Moorfields Eye Hospital, London, UK.
University Eye Hospital Munich, Ludwig-Maximilians-University, Munich, Germany.
Acta Ophthalmol. 2019 Dec;97(8):e1035-e1040. doi: 10.1111/aos.14106. Epub 2019 Jul 8.
To evaluate the detection of different lesions of diabetic retinopathy (DR) in scanning laser ophthalmoscopy (SLO) compared to colour fundus photographs within the same retinal field.
Scanning laser ophthalmoscopy and colour fundus photographs of 67 eyes taken on the same day of dilated patients with different grades of diabetic retinopathy were retrospectively examined. SLO images were then cropped to match the size and position of its 45-degree colour fundus photograph equivalent. Five independent masked graders assessed the images. Features of DR including haemorrhages, microaneurysms, exudates, cotton wool spots, intraretinal microvascular abnormalities, venous beading and neovascularization were analysed. Additionally, each image was classified according to Early Treatment of Diabetic Retinopathy Study (ETDRS) grading and English Diabetic Eye Screening Programme (DESP) grading.
There was moderate to good agreement in ETDRS and DESP grading between SLO and colour fundus photographs within individual graders (weighted kappa range 0.45-0.65). The average number of microaneurysms for SLO and colour photographs showed a high degree of agreement (ICC: 0.92). Equally, the average number of blot haemorrhages in SLO and colour images showed strong agreement (ICC: 0.98) and the average number of cotton wool spots in SLO and colour images correlated well (ICC: 0.92). For these three lesions, the intergrader reliability was good (ICC ≥0.66) for both modalities.
There was good correlation in detected microaneurysms, blot haemorrhages and cotton wool spots between SLO and colour fundus photographs. However, there was intergrader variability in flame haemorrhage, intraretinal microvascular abnormalities, venous beading and neovascularization grading with both modalities.
评估扫描激光检眼镜（SLO）与同一视网膜区域内彩色眼底照片相比，对糖尿病性视网膜病变（DR）不同病变的检测。
回顾性分析 67 只患有不同程度糖尿病性视网膜病变的散瞳患者同一天拍摄的 SLO 和彩色眼底照片。然后将 SLO 图像裁剪为与其 45 度彩色眼底照片等效的大小和位置。五位独立的盲法评估员评估图像。分析 DR 的特征包括出血、微动脉瘤、渗出物、棉絮斑、视网膜内微血管异常、静脉珠和新生血管形成。此外，根据早期糖尿病视网膜病变治疗研究（ETDRS）分级和英国糖尿病眼病筛查计划（DESP）分级对每个图像进行分类。
个别评估员的 SLO 和彩色眼底照片之间的 ETDRS 和 DESP 分级具有中度至良好的一致性（加权kappa 范围 0.45-0.65）。SLO 和彩色照片的平均微动脉瘤数量具有高度一致性（ICC：0.92）。同样，SLO 和彩色图像中的平均斑状出血数量具有很强的一致性（ICC：0.98），SLO 和彩色图像中的平均棉絮斑数量也具有很好的相关性（ICC：0.92）。对于这三种病变，两种模式的组内可靠性均较好（ICC≥0.66）。
SLO 和彩色眼底照片之间的微动脉瘤、斑状出血和棉絮斑检测结果相关性较好。然而，两种模式的火焰状出血、视网膜内微血管异常、静脉珠和新生血管形成分级的组内变异性较大。
