Ultra-widefield imaging prognostic in some DR cases
KOLOA, Hawaii — Ultra-widefield imaging of patients with diabetes has prognostic implications, Rishi P. Singh, MD, said at Retina 2020.
A study by Silva and colleagues in Ophthalmology looking at distribution of diabetic retinopathy lesions found hemorrhages, microaneurysms, intraretinal microvascular abnormalities and new vessel formation outside the area of the gold standard ETDRS 7-field imaging, suggesting a more severe assessment of diabetic retinopathy in 10% of eyes imaged with ultra-widefield technology, Singh said.
“This means that your patients with predominantly peripheral lesions outside the seven standard fields have an almost 3.2-fold rate of progression over those who do not,” Singh said.
More recently, Aiello and colleagues published results of the DRCR Retina Network Protocol AA, a longitudinal study of ETDRS 7-field photos and UWF to assess type, location and severity of peripheral lesions. The peripheral lesions found in that study implied increased diabetic retinopathy severity of two or more steps in 11% of eyes, Singh said.
“So when you get a diabetic patient in your practice for the first time, and you see a lot of peripheral lesions, that’s a patient whose going to progress in a rapid timeframe at a greater rate than someone without,” Singh said, adding that he closely monitors those patients with widefield imaging – by Patricia Nale, ELS
Aiello P, et al. JAMA Ophthalmol. doi:10.1001/jamaophthalmol.2018.4982.
Silva PS, et al. Ophthalmology. 2013;doi:10.1016/j.ophtha.2013.05.004.
Singh RP. Applying DRCR Retina Network protocols to clinical practice. Presented at: Retina 2020; Jan. 19-24, 2020; Koloa, Hawaii.
Disclosure: Singh reports conducting sponsored research for Aerie, Apellis and Graybug; and consulting for Bausch + Lomb, Genentech, Novartis, Regeneron and Zeiss.