Combined wide

Jul 25, 2023

Eye (2023)Cite this article

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To detect retinal neovascularization elsewhere (NVE), of the optic disc (NVD) and intraretinal microvascular abnormalities (IRMA) in treatment naive diabetic retinopathy (DR) and compare these findings by using 90° Wide-Field Colour Fundus Photography (WF CFP), Wide-Field Spectral-Domain Optical Coherence Tomography Angiography (OCTA) and the combination of WF CFP and OCTA through overlay software.

Patients with treatment naive severe non-proliferative DR or proliferative DR were prospectively enrolled. All patients underwent WF-CFP and OCTA in the same day. Two readers independently analysed WF-CFP, SD-OCTA and the overlay of the two techniques. The degree of agreement between the two raters and between different techniques (WF CFP, OCTA, WF CFP combined to OCTA) were measured with Cohen’s Kappa coefficient.

Thirty-one eyes from 21 patients (10 males, mean age 63 ± 15 years) were included. Inter-rater agreement by using WF-CFP in detection of NVE, NVD and IRMA was respectively 0.62, 0.22 and 0.55. OCTA scored values of inter-rater agreement of 0.86, 0.87 and 0.92 in detection of NVE, NVD and IRMA, respectively. By combining WF-CFP and SD-OCTA, inter-rater agreement in detection of NVE, NVD and IRMA was 0.93, 0.94 and 0.89, respectively.

Inter-rater agreement in detection of NVE, NVD and IRMA was substantial, fair and moderate, respectively. OCTA provided almost perfect values of inter-rater agreement in NVE, NVD and IRMA detection. Combining WF-CFP and OCTA further empowered concordance values in detection of NVE and NVD. Combining OCTA and WF-CFP is the best performance to detect NVE and NVD.

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The data that support the findings of this study are not openly available due to reasons of sensitivity and are available from the corresponding author upon reasonable request. Data are located in controlled access data storage at IRCCS Ospedale San Raffaele.

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School of Medicine, Vita-Salute San Raffaele University, Milan, Italy

Matteo Menean, Riccardo Sacconi, Beatrice Tombolini, Federico Fantaguzzi, Francesco Bandello & Giuseppe Querques

Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, Milan, Italy

Matteo Menean, Riccardo Sacconi, Beatrice Tombolini, Federico Fantaguzzi, Francesco Bandello & Giuseppe Querques

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All the authors contributed to the conception or design of the work, the acquisition, analysis, and interpretation of data, drafting the work, and revising it critically for important intellectual content. Each coauthor has seen and agrees with how his name is listed.

Correspondence to Giuseppe Querques.

MM, BT, FF have nothing to disclose. RS has the following disclosures: Allergan Inc, Bayer Shering-Pharma, Medivis, Novartis, Zeiss. FB has the following disclosures: Allergan Inc, Bayer Shering-Pharma, Boehringer-Ingelheim, Fidia Sooft, Hofmann La Roche, Novartis, NTC Pharma, Oxurion NV, Sifi. GQ has the following disclosures: Alimera Sciences, Allergan Inc, Amgen, Bayer Shering-Pharma, Heidelberg, KBH, LEH Pharma, Lumithera, Novartis, Sandoz, Sifi, Sooft-Fidea, Zeiss. The authors have no competing interest in publishing the present work.

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Menean, M., Sacconi, R., Tombolini, B. et al. Combined wide-field imaging in grading diabetic retinopathy. Eye (2023). https://doi.org/10.1038/s41433-023-02666-x

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Received: 27 October 2022

Revised: 25 June 2023

Accepted: 14 July 2023

Published: 31 July 2023

DOI: https://doi.org/10.1038/s41433-023-02666-x

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