학술논문
Comparison of diabetic retinopathy severity grading on ETDRS 7-field versus ultrawide-field assessment.
Document Type
Academic Journal
Author
Attiku Y; Doheny Eye Institute, Pasadena, CA, USA.; Nittala MG; Doheny Eye Institute, Pasadena, CA, USA.; Velaga SB; Doheny Eye Institute, Pasadena, CA, USA.; Ramachandra C; Eyenuk, Inc, Woodland Hills, CA, USA.; Bhat S; Eyenuk, Inc, Woodland Hills, CA, USA.; Solanki K; Eyenuk, Inc, Woodland Hills, CA, USA.; Jayadev C; Department of Cataract and Refractive Lens Surgery, Narayana Nethralaya, Bengaluru, India.; Choudhry N; Vitreous Retina Macula Specialists of Toronto, Toronto, Ontario, Canada.; Octane Imaging Lab, Toronto, Ontario, Canada.; Orr SMA; Vitreous Retina Macula Specialists of Toronto, Toronto, Ontario, Canada.; Octane Imaging Lab, Toronto, Ontario, Canada.; Jiang S; Vitreous Retina Macula Specialists of Toronto, Toronto, Ontario, Canada.; Octane Imaging Lab, Toronto, Ontario, Canada.; University of Calgary, Calgary, Alberta, Canada.; He Y; Doheny Eye Institute, Pasadena, CA, USA.; Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin, China.; Tianjin Branch of National Clinical Research Center for Ocular Disease, Tianjin, China.; Tianjin Medical University Eye Institute, Tianjin, China.; Sadda SR; Doheny Eye Institute, Pasadena, CA, USA. ssadda@doheny.org.; Department of Ophthalmology, University of California Los Angeles, Los Angeles, CA, USA. ssadda@doheny.org.
Source
Publisher: Nature Publishing Group Country of Publication: England NLM ID: 8703986 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1476-5454 (Electronic) Linking ISSN: 0950222X NLM ISO Abbreviation: Eye (Lond) Subsets: MEDLINE
Subject
Language
English
Abstract
Objectives: To compare the diabetic retinopathy (DR) severity level determined when considering only the ETDRS 7-field region versus the entire ultrawidefield (UWF) image.
Methods: In this retrospective, cross-sectional study, UWF pseudocolor images were graded on the Eyenuk image viewing, grading, and annotation platform for the severity of DR considering only the regions within the ETDRS 7-fields as well as the entire UWF image using two different protocols: 1) the simple International Classification of Diabetic Retinopathy (ICDR) scale and 2) the more complex DRCR.net Protocol AA grading scale.
Results: A total of 250 eyes from 157 patients were included in this analysis. Six eyes (2.4%) demonstrated a discrepancy in severity level between the ETDRS 7-field region and the entire UWF image when using the ICDR classification system. The discrepancies were due to the presence of lesions [intraretinal haemorrhage (n = 2), neovascular disease (n = 4)] in the peripheral fields which were not identified in the ETDRS 7-fields. Fourteen eyes (5.6%) had a discrepancy in severity level between the ETDRS 7-field region and the entire UWF image when using the ETDRS DRSS Protocol AA grading scale. The discrepancies were due to the presence of a higher level of disease [intraretinal haemorrhage (n = 4), neovascularization (n = 4), preretinal haemorrhage (n = 2), scatter laser scars (n = 4)] in the peripheral fields.
Conclusion: Although considering regions outside of the ETDRS 7-fields altered the DR severity level assessment in <5% of cases in this cohort, significant and potentially vision-threatening lesions including neovascularization and preretinal haemorrhage were identified in these peripheral regions. This highlights the importance of evaluating the entire UWF region when assessing patients with diabetic retinopathy.
(© 2023. The Author(s).)
Methods: In this retrospective, cross-sectional study, UWF pseudocolor images were graded on the Eyenuk image viewing, grading, and annotation platform for the severity of DR considering only the regions within the ETDRS 7-fields as well as the entire UWF image using two different protocols: 1) the simple International Classification of Diabetic Retinopathy (ICDR) scale and 2) the more complex DRCR.net Protocol AA grading scale.
Results: A total of 250 eyes from 157 patients were included in this analysis. Six eyes (2.4%) demonstrated a discrepancy in severity level between the ETDRS 7-field region and the entire UWF image when using the ICDR classification system. The discrepancies were due to the presence of lesions [intraretinal haemorrhage (n = 2), neovascular disease (n = 4)] in the peripheral fields which were not identified in the ETDRS 7-fields. Fourteen eyes (5.6%) had a discrepancy in severity level between the ETDRS 7-field region and the entire UWF image when using the ETDRS DRSS Protocol AA grading scale. The discrepancies were due to the presence of a higher level of disease [intraretinal haemorrhage (n = 4), neovascularization (n = 4), preretinal haemorrhage (n = 2), scatter laser scars (n = 4)] in the peripheral fields.
Conclusion: Although considering regions outside of the ETDRS 7-fields altered the DR severity level assessment in <5% of cases in this cohort, significant and potentially vision-threatening lesions including neovascularization and preretinal haemorrhage were identified in these peripheral regions. This highlights the importance of evaluating the entire UWF region when assessing patients with diabetic retinopathy.
(© 2023. The Author(s).)