normal retina vs diabetic retinopathy optomap

Specifically, it recommended using virtual clinics to follow up stable moderate non proliferative diabetic retinopathy if sufficient retinal coverage can be achieved at adequate quality by the available imaging modalities. It published ‘The Way Forward’ documents in 2015 to identify new methods and ways of working to meet the increasing demand for ophthalmic services. The Royal College of Ophthalmologists anticipated a 60% increase in the diabetic retinopathy (DR) case load over the next 20 years. The prevalence of diabetes in UK and the world is expected to grow further due to ageing and higher rates of obesity. If the fundus photographs show any pathology that might require monitoring or treatment by a specialist, or if the photographs are of inadequate quality, then the patient will be referred to the hospital eye clinic for further management. This will give a combined field of about 60° wide. In England, two fundus photographs of 45° each are used per eye, one centred on the fovea and the other centred on the disc. It offers annual screening with fundus photographs to all diabetic patients aged 12 or over. The National Health Service (NHS) Diabetic Eye Screening Programme (DESP) in UK has been operational since 2003. Widefield Clarus and OCT imaging allowed two-thirds of DESP referrals to be safely managed virtually. One case of slit lamp noted retinal neovascularization, which was graded as background retinopathy by DESP was also graded as such on virtual assessment. Agreement of DR grading between both virtual graders and slit lamp examination was fair (Kappa’s coefficient = 0.56). Compared to slit lamp examination, 15% and 7.5% of patients from G1 and G2’s virtual assessment respectively had different proposed management plan. Eighteen (35%) patients and 11 (22%) patients from virtual assessment by G1 and G2, respectively were found to need a face a face appointment to aid diagnosis. 11 fundus photos from 7 patients and 15 fundus photos from 10 patients were deemed inadequate by grader G1 and G2, respectively. One-hundred and two eyes of 51 patients were assessed. Results from virtual examination were compared with those from slit lamp examination. Two graders retrospectively reviewed imaging and formulated a management plan blinded to results from patients’ clinic visit. Data obtained from electronic patient records included referral reason, DR grading and management plan. All patients underwent slit lamp examination in clinic. Patients who had both Clarus widefield imaging and macular OCT were included.

New referrals over 3 months from the National Diabetic Eye Screening programme (DESP) were screened. To compare diabetic retinopathy (DR) grading and management plan between virtual review using widefield Clarus imaging and macular optical coherence tomography (OCT) versus slit lamp clinical examination and macular OCT.

Normal retina vs diabetic retinopathy optomap