Blue Widefield Images of Scanning Laser Ophthalmoscope Can Detect Retinal Ischemic Areas in Eyes With Diabetic Retinopathy

Abstract

Diabetic retinopathy (DR) is one of the leading causes of blindness worldwide. The retinal ischemic changes in DR need to be detected and treated appropriately to prevent further progression. At present, fluorescein angiography (FA) is the most commonly used method to detect the ischemic areas. We present our results that showed a practical method of detecting retinal ischemic area covering mid-peripheral retina by multicolor widefield scanning laser ophthalmoscopy (SLO) without fluorescein. Ninety patients with and 50 patients without diabetes mellitus were studied retrospectively. All had undergone multicolor widefield SLO imaging. Hyporeflective areas in blue image of SLO were found in the incidence of 76.6% in eyes with proliferative DR eyes. In a comparison of the hyporeflective areas of the blue SLO images to the non-perfused areas in the FA images, the appearance and the correspondence in the locations of these findings in the two types of images were found, and the incidence were highly concordant with Cohen kappa value of 0.785. The high concordance between the hyporeflective areas in the wide-field blue SLO images and the NPAs in the FA images indicates that this method can be clinically useful to identify ischemic retinal areas in DR.