Imaging Modalities for Assessing the Vascular Component of Diabetic Retinal Disease: Review and Consensus for an...

Area of Science:

• Ophthalmology
• Medical Imaging
• Diabetic Retinopathy Research

Background:

• Diabetic retinal disease (DRD) staging relies on accurate vascular assessment.
• Current staging systems require updates to incorporate advancements in imaging technology.

Purpose of the Study:

• To review evidence for various imaging modalities in assessing the vascular component of DRD.
• To inform updates to the diabetic retinal disease staging system.

Main Methods:

• A standardized narrative literature review was performed by an international expert workgroup.
• Evidence levels (I-V) were determined for standard color fundus photography (CFP), widefield color photography (WFCP), standard fluorescein angiography (FA), widefield FA (WFFA), and OCT angiography (OCTA).
• Consensus was reached through virtual workshops.

Main Results:

• Standard CFP and FA (Level I evidence) remain crucial for DRD staging.
• WFCP and OCTA (Level II evidence) show potential but need further validation and clarification for grading.
• WFFA also provides prognostic value (Level I evidence), though dye administration is a consideration.

Conclusions:

• Evidence-based recommendations are provided for incorporating imaging modalities into DRD staging.
• While advanced imaging offers significant potential, research gaps must be addressed before full integration into DRD staging systems.