In a clinical trial led by Joslin Diabetes Center's Beetham Eye Institute new Ultra Widefield (UWF) scanning technology has been demonstrated to drastically increase the ability for doctors to identify diabetic retinopathy in patients, and help determine if the condition is bad enough to refer them to an ophthalmologist. The results of this study, which involved 25,000 patients in the United States, confirm findings from smaller studies done previously.
Researchers showed that by using UWF scanning technology, reduces the number of ungradable images by 81% when compared to previous methods. "These data demonstrate that when we deploy this technology in a community-based setting, we can achieve the same magnitude of reduction in ungradable images and increased identification of eye disease as we saw in the academic research environment," says Paolo Silva, M.D., staff ophthalmologist and assistant chief of telemedicine, and lead author on a paper appearing in the journal Ophthalmology.
The current standard is Traditional Early Treatment Diabetic Retinopathy Study (ETDRS), has been in use for decades, and uses a series of 7 separate retinal photographs to image approximate 30% of the retina. By comparison, UWF imaging offers significantly better results, with 82% of the retina being visible in high resolution.
Although, these results aren't perfect; the chance of having an un-gradable UWF image result increases with age, as people with diabetes are more likely to develop cataracts, with interfere with the imaging process. The equipment is also much more expensive. Each machine has a price tag of £48,500. Even taking these problems into account, the results are still much better when compared to the standard ETDRS method.
An unintended discovery was that approximately 10% of patients scanned showed signs of peripheral retinal disease. The lesions caused by peripheral retinal disease exist outside the area normally scanned with ETDRS. The ability to detect symptoms of two diseases at once helps doctors better predict which eyes are more likely to progress to more advanced stages of diabetic retinopathy.
"Utilizing this new type of camera technology, we can more easily obtain the images, we can read the retinal images faster, we have fewer images that are unusable, and we pick up more disease than we could in the past," says Lloyd Paul Aiello, M.D., Ph.D., Director of the Beetham Institute, Professor of Ophthalmology at Harvard Medical School and senior author on the paper.. "And we have now shown this substantial benefit in a large real-world setting."