The role of the macular interface in the diagnosis of retinopathy of prematurity and diabetic angioretinopathy

Abstract

Vitreomacular interface is an important part of the diagnosis from retinopathy of prematurity (ROP) to retinal diseases in adults. It is required to develop a method for macula localization to determine 3 stable points for photographic measurements of a 3D eye model. Purpose. To minimize the risk of mistakes in the diagnosis and choice of treatment for ROP and diabetic angioretinopathy (DARP) by improving the quality and analysis of modeled wide-field images on the Key to Diagnosis I and II platforms. Material and methods. 1278 RetCam and fundus images of 402 patients. 3 clinical groups: 1 – ROP 272 (544 eyes): 1A – I stage 152(304 eyes), 1B – II stage 45 (90 eyes), 1C – III stage 8 (12 eyes), 1D – posterior aggressive ROP 7 (14 eyes), 1E-retinal immaturity 60 (120 eyes); 2 – DARP 120 (240 eyes): 2A – non-proliferative 13 (17 eyes), 2B – preproliferative 47 (55 eyes), 2C – proliferative 27 (33 eyes), 2D – terminal 33 (37 eyes), 3 – control 10 (20 eyes). A standard clinical examination, analysis of modeled wide-field images, localization of the macula and traction index of the macular region (Tm) were performed. Results. Platform modules have been developed for automatic wide-field images modeling and macular localization, which is a reference point for assessing the extent of pathological changes. In ROP there was significant negative correlation of the Tm value with a stage: 1А – 0,8±0,03, 1B – 0,75±0,04, 1C – 0,74±0,13, 1D – 0,99±0,01, 1E – 0,91±0,09. For groups 2A – 2B, there was no correlation between Tm and the DARP severity. Conclusion. Tm reflects the severity of traction processes at the periphery of the retina and can be used as a marker in case of diagnostic defects in ROP. The localization of the macula determines the stable points for automatic morphometry. Key words: retinopathy of prematurity, pediatric retinal camera RetCam-Shuttle, telemedicine, diabetic angioretinopathy, vitreomacular interface.