Imaging Modalities Employed in Diabetic Retinopathy Screening : A Review and Meta-Analysis

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Kanclerz , P , Tuuminen , R & Khoramnia , R 2021 , ' Imaging Modalities Employed in Diabetic Retinopathy Screening : A Review and Meta-Analysis ' , Diagnostics , vol. 11 , no. 10 , 1802 . https://doi.org/10.3390/diagnostics11101802

Title: Imaging Modalities Employed in Diabetic Retinopathy Screening : A Review and Meta-Analysis
Author: Kanclerz, Piotr; Tuuminen, Raimo; Khoramnia, Ramin
Contributor organization: Korva-, nenä- ja kurkkutautien klinikka
Clinicum
HUS Head and Neck Center
Kymsote – Social and Health Services in Kymenlaakso
HYKS erva
Date: 2021-10
Language: eng
Number of pages: 27
Belongs to series: Diagnostics
ISSN: 2075-4418
DOI: https://doi.org/10.3390/diagnostics11101802
URI: http://hdl.handle.net/10138/337231
Abstract: Introduction: Urbanization has caused dramatic changes in lifestyle, and these rapid transitions have led to an increased risk of noncommunicable diseases, such as type 2 diabetes. In terms of cost-effectiveness, screening for diabetic retinopathy is a critical aspect in diabetes management. The aim of this study was to review the imaging modalities employed for retinal examination in diabetic retinopathy screening. Methods: The PubMed and Web of Science databases were the main sources used to investigate the medical literature. An extensive search was performed to identify relevant articles concerning "imaging ", "diabetic retinopathy " and "screening " up to 1 June 2021. Imaging techniques were divided into the following: (i) mydriatic fundus photography, (ii) non-mydriatic fundus photography, (iii) smartphone-based imaging, and (iv) ultrawide-field imaging. A meta-analysis was performed to analyze the performance and technical failure rate of each method. Results: The technical failure rates for mydriatic and non-mydriatic digital fundus photography, smartphone-based and ultrawide-field imaging were 3.4% (95% CI: 2.3-4.6%), 12.1% (95% CI: 5.4-18.7%), 5.3% (95% CI: 1.5-9.0%) and 2.2% (95% CI: 0.3-4.0%), respectively. The rate was significantly different between all analyzed techniques (p < 0.001), and the overall failure rate was 6.6% (4.9-8.3%; I-2 = 97.2%). The publication bias factor for smartphone-based imaging was significantly higher than for mydriatic digital fundus photography and non-mydriatic digital fundus photography (b = -8.61, b = -2.59 and b = -7.03, respectively; p < 0.001). Ultrawide-field imaging studies were excluded from the final sensitivity/specificity analysis, as the total number of patients included was too small. Conclusions: Regardless of the type of the device used, retinal photographs should be taken on eyes with dilated pupils, unless contraindicated, as this setting decreases the rate of ungradable images. Smartphone-based and ultrawide-field imaging may become potential alternative methods for optimized DR screening; however, there is not yet enough evidence for these techniques to displace mydriatic fundus photography.
Subject: diabetic retinopathy
fundus photography
mydriatic photography
screening
smartphone-based imaging
ultra-wide-field scanning laser ophthalmoscope
diabetic macular edema
OPTICAL COHERENCE TOMOGRAPHY
NONMYDRIATIC FUNDUS PHOTOGRAPHY
SCANNING LASER OPHTHALMOSCOPY
MACULAR EDEMA
SMARTPHONE OPHTHALMOSCOPY
RETINAL PHOTOGRAPHY
CHOROIDAL THICKNESS
VISUAL-ACUITY
RISK-FACTORS
SLIT-LAMP
3121 General medicine, internal medicine and other clinical medicine
Peer reviewed: Yes
Rights: cc_by
Usage restriction: openAccess
Self-archived version: publishedVersion


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