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UWF imaging could change diabetic retinopathy care and treatment

A new class of ultrawide field (UWF) cameras may lead to new ways of diagnosing and treating diabetic eye disease.
UWF systems generate high-resolution images extremely quickly, which can be evaluated more efficiently by experts than conventional ETDRS (Early Treatment Diabetic Retinopathy Study) photos, according to Paolo Silva, M.D., at the Joslin Diabetes Centre’s Beetham Eye Institute.
The results of a study conducted at Joslin revealed that UWF images detect diabetic retinal lesions predominantly in peripheral areas of the retina, but these are not picked up by traditional retinal photographs.
These lesions were shown by Joslin researchers to increase the risk of progressing to advanced stages of vision-threatening diabetic retinopathy.
For their study, 100 people with diabetes participated in a follow-up study to a trial which previously showed that diabetic retinal lesions are present in a third of patients, increasing the severity of retinopathy in 10 per cent of eyes.
In this new prospective study, participants had further retinal imaging four years afterwards. Those with predominantly peripheral diabetic retinopathy lesions had over a three-fold increased risk of retinopathy progressing. The risk of progression to proliferative diabetic retinopathy – which can cause blindness – increased five-fold.
Senior author Lloyd Paul Aiello, M.D., PhD, Director of the Beetham Institute, Professor of Ophthalmology at Harvard Medical School, said: “What was a big surprise is how much of a risk this added and how much of the disease was found outside of the area we’ve traditionally evaluated.”
Further trials are now underway in the United States: 350 diabetes patients are being evaluated with UWF imaging over a four-year period, which could lead to changes in care and research for diabetes patients.
Furthermore, the rating of disease progression in diabetic retinopathy could be altered in the US and the United Kingdom if the results from this Joslin study are confirmed in larger studies.

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