Scanning laser ophthalmoscopy in the retromode in diabetic macular oedema

Stela Vujosevic, Barbara Trento, Elisa Bottega, Francesca Urban, Elisabetta Pilotto, Edoardo Midena

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Purpose: To determine the validity of scanning laser ophthalmoscopy in the retromode (RM-SLO) versus other imaging modalities in the diagnosis of diabetic macular oedema (DME). Methods: Two hundred and sixty-three eyes were examined. Inclusion criteria were any stage of untreated or treated diabetic retinopathy and four imaging modalities of the macula carried out on the same day: time domain optical coherence tomography (OCT), fundus autofluorescence (FAF), RM-SLO and fluorescein angiography (FA). Two masked retinal specialists independently graded all images. Agreement between RM-SLO and OCT, FA and FAF in evaluating the presence and patterns of DME was evaluated by kappa statistics, sensitivity, specificity, observed proportional agreement, and proportional agreement in positive and negative cases. Results: The agreement in evaluating the presence/absence of DME between RM-SLO and OCT, FA and FAF was good: Î = 0.73 (confidence interval; CI, 0.64-0.83), Î = 0.71 (CI, 0.61-0.81) and Î = 0.73 (CI, 0.63-0.83), respectively. The agreement in evaluating cystoid pattern of DME was almost perfect between RM-SLO and OCT, RM-SLO and FA, Î > 0.8; and good between RM-SLO and FAF, Î > 0.7. The agreement in evaluating the presence/absence of subfoveal neuroretinal was almost perfect between RM-SLO and OCT (Î = 0.83; 95% CI, 0.70-0.96). Subfoveal neuroretinal detachment did not show any specific pattern on FA or FAF. Sensitivity and specificity of RM-SLO in evaluating DME was 97.7% and 71.9% versus OCT, 97.4% and 68.1% versus FA and 96.1% and 73.3% versus FAF. Retinal thickness of 233 μm represented the cut-off value to define DME by RM-SLO. Conclusions: The combined use of non-invasive imaging techniques can improve the diagnostic interpretation of different aspects of DME.

Original languageEnglish
JournalActa Ophthalmologica
Volume90
Issue number5
DOIs
Publication statusPublished - Aug 2012

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Ophthalmoscopy
Macular Edema
Fluorescein Angiography
Optical Coherence Tomography
Lasers
Sensitivity and Specificity
Diabetic Retinopathy
Confidence Intervals

Keywords

  • diabetic macular oedema
  • fluorescein angiography
  • fundus autofluorescence
  • optical coherence tomography
  • retromode
  • scanning laser ophthalmoscopy

ASJC Scopus subject areas

  • Ophthalmology

Cite this

Scanning laser ophthalmoscopy in the retromode in diabetic macular oedema. / Vujosevic, Stela; Trento, Barbara; Bottega, Elisa; Urban, Francesca; Pilotto, Elisabetta; Midena, Edoardo.

In: Acta Ophthalmologica, Vol. 90, No. 5, 08.2012.

Research output: Contribution to journalArticle

Vujosevic, Stela ; Trento, Barbara ; Bottega, Elisa ; Urban, Francesca ; Pilotto, Elisabetta ; Midena, Edoardo. / Scanning laser ophthalmoscopy in the retromode in diabetic macular oedema. In: Acta Ophthalmologica. 2012 ; Vol. 90, No. 5.
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abstract = "Purpose: To determine the validity of scanning laser ophthalmoscopy in the retromode (RM-SLO) versus other imaging modalities in the diagnosis of diabetic macular oedema (DME). Methods: Two hundred and sixty-three eyes were examined. Inclusion criteria were any stage of untreated or treated diabetic retinopathy and four imaging modalities of the macula carried out on the same day: time domain optical coherence tomography (OCT), fundus autofluorescence (FAF), RM-SLO and fluorescein angiography (FA). Two masked retinal specialists independently graded all images. Agreement between RM-SLO and OCT, FA and FAF in evaluating the presence and patterns of DME was evaluated by kappa statistics, sensitivity, specificity, observed proportional agreement, and proportional agreement in positive and negative cases. Results: The agreement in evaluating the presence/absence of DME between RM-SLO and OCT, FA and FAF was good: {\^I} = 0.73 (confidence interval; CI, 0.64-0.83), {\^I} = 0.71 (CI, 0.61-0.81) and {\^I} = 0.73 (CI, 0.63-0.83), respectively. The agreement in evaluating cystoid pattern of DME was almost perfect between RM-SLO and OCT, RM-SLO and FA, {\^I} > 0.8; and good between RM-SLO and FAF, {\^I} > 0.7. The agreement in evaluating the presence/absence of subfoveal neuroretinal was almost perfect between RM-SLO and OCT ({\^I} = 0.83; 95{\%} CI, 0.70-0.96). Subfoveal neuroretinal detachment did not show any specific pattern on FA or FAF. Sensitivity and specificity of RM-SLO in evaluating DME was 97.7{\%} and 71.9{\%} versus OCT, 97.4{\%} and 68.1{\%} versus FA and 96.1{\%} and 73.3{\%} versus FAF. Retinal thickness of 233 μm represented the cut-off value to define DME by RM-SLO. Conclusions: The combined use of non-invasive imaging techniques can improve the diagnostic interpretation of different aspects of DME.",
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AU - Bottega, Elisa

AU - Urban, Francesca

AU - Pilotto, Elisabetta

AU - Midena, Edoardo

PY - 2012/8

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N2 - Purpose: To determine the validity of scanning laser ophthalmoscopy in the retromode (RM-SLO) versus other imaging modalities in the diagnosis of diabetic macular oedema (DME). Methods: Two hundred and sixty-three eyes were examined. Inclusion criteria were any stage of untreated or treated diabetic retinopathy and four imaging modalities of the macula carried out on the same day: time domain optical coherence tomography (OCT), fundus autofluorescence (FAF), RM-SLO and fluorescein angiography (FA). Two masked retinal specialists independently graded all images. Agreement between RM-SLO and OCT, FA and FAF in evaluating the presence and patterns of DME was evaluated by kappa statistics, sensitivity, specificity, observed proportional agreement, and proportional agreement in positive and negative cases. Results: The agreement in evaluating the presence/absence of DME between RM-SLO and OCT, FA and FAF was good: Î = 0.73 (confidence interval; CI, 0.64-0.83), Î = 0.71 (CI, 0.61-0.81) and Î = 0.73 (CI, 0.63-0.83), respectively. The agreement in evaluating cystoid pattern of DME was almost perfect between RM-SLO and OCT, RM-SLO and FA, Î > 0.8; and good between RM-SLO and FAF, Î > 0.7. The agreement in evaluating the presence/absence of subfoveal neuroretinal was almost perfect between RM-SLO and OCT (Î = 0.83; 95% CI, 0.70-0.96). Subfoveal neuroretinal detachment did not show any specific pattern on FA or FAF. Sensitivity and specificity of RM-SLO in evaluating DME was 97.7% and 71.9% versus OCT, 97.4% and 68.1% versus FA and 96.1% and 73.3% versus FAF. Retinal thickness of 233 μm represented the cut-off value to define DME by RM-SLO. Conclusions: The combined use of non-invasive imaging techniques can improve the diagnostic interpretation of different aspects of DME.

AB - Purpose: To determine the validity of scanning laser ophthalmoscopy in the retromode (RM-SLO) versus other imaging modalities in the diagnosis of diabetic macular oedema (DME). Methods: Two hundred and sixty-three eyes were examined. Inclusion criteria were any stage of untreated or treated diabetic retinopathy and four imaging modalities of the macula carried out on the same day: time domain optical coherence tomography (OCT), fundus autofluorescence (FAF), RM-SLO and fluorescein angiography (FA). Two masked retinal specialists independently graded all images. Agreement between RM-SLO and OCT, FA and FAF in evaluating the presence and patterns of DME was evaluated by kappa statistics, sensitivity, specificity, observed proportional agreement, and proportional agreement in positive and negative cases. Results: The agreement in evaluating the presence/absence of DME between RM-SLO and OCT, FA and FAF was good: Î = 0.73 (confidence interval; CI, 0.64-0.83), Î = 0.71 (CI, 0.61-0.81) and Î = 0.73 (CI, 0.63-0.83), respectively. The agreement in evaluating cystoid pattern of DME was almost perfect between RM-SLO and OCT, RM-SLO and FA, Î > 0.8; and good between RM-SLO and FAF, Î > 0.7. The agreement in evaluating the presence/absence of subfoveal neuroretinal was almost perfect between RM-SLO and OCT (Î = 0.83; 95% CI, 0.70-0.96). Subfoveal neuroretinal detachment did not show any specific pattern on FA or FAF. Sensitivity and specificity of RM-SLO in evaluating DME was 97.7% and 71.9% versus OCT, 97.4% and 68.1% versus FA and 96.1% and 73.3% versus FAF. Retinal thickness of 233 μm represented the cut-off value to define DME by RM-SLO. Conclusions: The combined use of non-invasive imaging techniques can improve the diagnostic interpretation of different aspects of DME.

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KW - optical coherence tomography

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KW - scanning laser ophthalmoscopy

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