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Entoptic evaluation of diabetic retinopathy
R A Applegate1, A Bradley, W A van Heuven
1Department of Ophthalmology, University of Texas, Health Science Center at San Antonio 78284-6230, USA.
Investigative Ophthalmology & Visual Science
|April 1, 1997
Summary
Untrained patients with diabetes can visualize their own retinal defects using a vascular entoptoscope, aiding in early detection of diabetic retinopathy. This noninvasive method shows promise for monitoring disease progression.
Area of Science:
- Ophthalmology
- Diabetic Retinopathy Research
- Medical Imaging Techniques
Background:
- Optimized entoptic viewing reveals greater detail of retinal vasculature than fluorescein angiography.
- Previous studies demonstrated normal subjects' ability to see their own capillaries with high detail.
Purpose of the Study:
- To evaluate the sensitivity, specificity, and accuracy of untrained individuals with diabetes in detecting their own parafoveal retinal defects using entoptic viewing.
- To assess the potential of entoptic testing for monitoring diabetic retinopathy.
Main Methods:
- A vascular entoptoscope with Maxwellian view optics was used to visualize parafoveal retinal vasculature.
- A double-masked protocol involved 70 patients with diabetes and 29 controls describing, drawing, and quantifying their entoptic images.
- Entoptic records were compared with concurrently obtained angiograms and color photographs.
Main Results:
- 61 of 70 diabetic patients had retinal defects; 51% detected these defects entoptically.
- Sensitivity and specificity for detecting parafoveal defects were 51% and 82%, respectively.
- Most subjects could quantify their foveal avascular zone (FAZ) size entoptically, exceeding the visibility in fluorescein angiograms.
Conclusions:
- Over half of untrained diabetic patients visualized their parafoveal retinopathy entoptically.
- Entoptic testing is a low-cost, noninvasive, and safe method for subjective monitoring of early parafoveal disease processes.
- This technique shows potential for clinical monitoring and research into the natural history of diabetic retinopathy.