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5. Periodontitis and Outer Retinal Thickness: a Cross-Sectional Analysis of the United Kingdom Biobank Cohort

Author

Allen, Naomi, Aslam, Tariq, Atan, Denize, Balaskas, Konsantinos, Barman, Sarah A., Barrett, Jenny H., Bishop, Paul, Black, Graeme, Braithwaite, Tasanee, Carare, Roxana O., Chakravarthy, Usha, Chan, Michelle, Chua, Sharon Y.L., Day, Alexander, Desai, Parul, Dhillon, Bal, Dick, Andrew D., Doney, Alexander, Egan, Cathy, Ennis, Sarah, Foster, Paul, Fruttiger, Marcus, Gallacher, John E.J., Garway-Heath, David F., Gibson, Jane, Guggenheim, Jeremy A., Hammond, Chris J., Hardcastle, Alison, Harding, Simon P., Hogg, Ruth E., Hysi, Pirro, Keane, Pearse A., Khaw, Sir Peng T., Khawaja, Anthony P., Lascaratos, Gerassimos, Littlejohns, Thoams, Lotery, Andrew J., Luben, Robert, Luthert, Phil, Macgillivray, Tom, Mackie, Sarah, McGuinness, Bernadette, McKay, Gareth J., McKibbin, Martin, Moore, Tony, Morgan, James E., O’Sullivan, Eoin, Oram, Richard, Owen, Chris G., Patel, Praveen, Paterson, Euan, Peto, Tunde, Petzold, Axel, Rahi, Jugnoo S., Rudnikca, Alicja R., Sattar, Naveed, Self, Jay, Sergouniotis, Panagiotis, Sivaprasad, Sobha, Steel, David, Stratton, Irene, Strouthidis, Nicholas, Sudlow, Cathie, Sun, Zihan, Tapp, Robyn, Thomas, Dhanes, Trucco, Emanuele, Tufail, Adnan, Vitart, Veronique, Viswanathan, Ananth C., Weedon, Mike, Williams, Cathy, Williams, Katie, Woodside, Jayne V., Yates, Max M., Yip, Jennifer, Zheng, Yalin, Wagner, Siegfried K., Patel, Praveen J., Huemer, Josef, Khalid, Hagar, Stuart, Kelsey V., Chu, Colin J., Williamson, Dominic J., Struyven, Robbert R., Romero-Bascones, David, Foster, Paul J., Balaskas, Konstantinos, Cortina-Borja, Mario, Chapple, Iain, Dietrich, Thomas, and Denniston, Alastair K.

Published
2024
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9. Real-World 1-Year Outcomes of Treatment-Intensive Neovascular Age-Related Macular Degeneration Switched to Faricimab

Author

Logeswaran, Abison, Tufail, Adnan, Gurbaxani, Avinash, Pal, Bishwanath, Egan, Catherine, Bessant, David, Thomas, Dhanes, Ling, Heng, Huemer, Josef, Basheer, Khadijah, Balaskas, Konstantinos, Bouras, Konstantinos, Nicholson, Luke, Lyndon Da Cruz, Natkunarajah, Mythili, Okhravi, Narciss, Islam, Niaz, Desai, Parul, Keane, Pearse, Addison, Peter, Patel, Praveen, Rajendram, Ranjan, Hamilton, Robin, Selvam, Senthil, Esposti, Simona, Sivaprasad, Sobha, Heeren, Tjebo, Rahman, Waheeda, Khan, Yasir, Ockrim, Zoe, Saihan, Zubin, Sim, Sing Yue, Chalkiadaki, Evangelia, Koutsocheras, Georgios, Patel, Praveen J., Keane, Pearse A., and Bhatia, Bhairavi

Published
2024
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14. Deep Learning to Detect OCT-derived Diabetic Macular Edema from Color Retinal Photographs: A Multicenter Validation Study

Author

Liu, Xinle, Ali, Tayyeba K., Singh, Preeti, Shah, Ami, McKinney, Scott Mayer, Ruamviboonsuk, Paisan, Turner, Angus W., Keane, Pearse A., Chotcomwongse, Peranut, Nganthavee, Variya, Chia, Mark, Huemer, Josef, Cuadros, Jorge, Raman, Rajiv, Corrado, Greg S., Peng, Lily, Webster, Dale R., Hammel, Naama, Varadarajan, Avinash V., Liu, Yun, Chopra, Reena, and Bavishi, Pinal

Published
2022
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15. Generative artificial intelligence in ophthalmology: current innovations, future applications and challenges.

Author

Sonmez, Sadi Can, Sevgi, Mertcan, Antaki, Fares, Huemer, Josef, and Keane, Pearse A.

Abstract

The rapid advancements in generative artificial intelligence are set to significantly influence the medical sector, particularly ophthalmology. Generative adversarial networks and diffusion models enable the creation of synthetic images, aiding the development of deep learning models tailored for specific imaging tasks. Additionally, the advent of multimodal foundational models, capable of generating images, text and videos, presents a broad spectrum of applications within ophthalmology. These range from enhancing diagnostic accuracy to improving patient education and training healthcare professionals. Despite the promising potential, this area of technology is still in its infancy, and there are several challenges to be addressed, including data bias, safety concerns and the practical implementation of these technologies in clinical settings. [ABSTRACT FROM AUTHOR]

Published
2024
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18. Exudative Progression of Treatment-Naïve Nonexudative Macular Neovascularization in Age-Related Macular Degeneration:A Systematic Review With Meta-Analyses

Author

Nissen, Anne Helene Køllund, Kiilgaard, Hans Christian, van Dijk, Elon H. C., Hajari, Javad Nouri, Huemer, Josef, Iovino, Claudio, Schneider, Miklos, Sørensen, Torben Lykke, Grauslund, Jakob, Subhi, Yousif, Nissen, Anne Helene Køllund, Kiilgaard, Hans Christian, van Dijk, Elon H. C., Hajari, Javad Nouri, Huemer, Josef, Iovino, Claudio, Schneider, Miklos, Sørensen, Torben Lykke, Grauslund, Jakob, and Subhi, Yousif

Abstract

PURPOSE: To systematically review and report the rate of exudative progression over time in patients with non-exudative macular neovascularization (MNV) in age-related macular degeneration (AMD).DESIGN: Systematic review with prevalence meta-analyses and individual participant meta-analysis.METHODS: We searched 10 literature databases on March 26, 2023, for studies of consecutive patients with treatment-naïve non-exudative MNV in AMD. The primary outcome of interest was time from diagnosis to exudative progression. We conducted meta-analyses on the prevalence of exudative progression at 1 and 2 years. Where possible, we extracted individual participant data from studies and conducted an individual participant meta-analysis and explored the exudative progression using a time-to-event curve.RESULTS: We identified 16 eligible studies with a total of 384 eyes with non-exudative MNV. Exudative progression had occurred in 20.9 % (95 % CI: 13.1-29.8) of eyes at 1 year and in 30.7% (95%CI: 21.8-40.4%) at 2 years. Similar results were observed in the individual participant meta-analysis, showing exudative progression in 18.9% (95%CI: 13.5-26.3%) of eyes at 1 year and 31.3% (95%CI: 24.2-40.0%) at 2 years. Risk factors for a fast exudative progression were the presence of subretinal lipid globules, large MNV areas, rapid MNV growth, growth in pigment epithelium detachment height and width, appearance of a branching pattern, and development of a hyporeflective halo around the MNV.CONCLUSIONS: Non-exudative MNVs in AMD are at high risk of exudative progression. Recognition of these lesions may allow for better individualized follow-up regimens in which closer monitoring may facilitate earlier diagnosis of exudative progression.

Published
2024

20. Periodontitis and outer retinal thickness: A cross-sectional analysis of the UK Biobank cohort

Author

Wagner, Siegfried K., primary, Patel, Praveen J., additional, Huemer, Josef, additional, Khalid, Hagar, additional, Stuart, Kelsey V., additional, Chu, Colin J., additional, Williamson, Dominic J., additional, Struyven, Robbert R., additional, Romero-Bascones, David, additional, Foster, Paul J., additional, Khawaja, Anthony P., additional, Petzold, Axel, additional, Balaskas, Konstantinos, additional, Cortina-Borja, Mario, additional, Chapple, Iain, additional, Dietrich, Thomas, additional, Rahi, Jugnoo S., additional, Denniston, Alastair K., additional, Keane, Pearse A., additional, Allen, Naomi, additional, Aslam, Tariq, additional, Atan, Denize, additional, Balaskas, Konsantinos, additional, Barman, Sarah A., additional, Barrett, Jenny H., additional, Bishop, Paul, additional, Black, Graeme, additional, Braithwaite, Tasanee, additional, Carare, Roxana O., additional, Chakravarthy, Usha, additional, Chan, Michelle, additional, Chua, Sharon Y.L., additional, Day, Alexander, additional, Desai, Parul, additional, Dhillon, Bal, additional, Dick, Andrew D., additional, Doney, Alexander, additional, Egan, Cathy, additional, Ennis, Sarah, additional, Foster, Paul, additional, Fruttiger, Marcus, additional, Gallacher, John E.J., additional, Garway-Heath, David F., additional, Gibson, Jane, additional, Guggenheim, Jeremy A., additional, Hammond, Chris J., additional, Hardcastle, Alison, additional, Harding, Simon P., additional, Hogg, Ruth E., additional, Hysi, Pirro, additional, Khaw, Sir Peng T., additional, Lascaratos, Gerassimos, additional, Littlejohns, Thoams, additional, Lotery, Andrew J., additional, Luben, Robert, additional, Luthert, Phil, additional, Macgillivray, Tom, additional, Mackie, Sarah, additional, McGuinness, Bernadette, additional, McKay, Gareth J., additional, McKibbin, Martin, additional, Moore, Tony, additional, Morgan, James E., additional, O’Sullivan, Eoin, additional, Oram, Richard, additional, Owen, Chris G., additional, Patel, Praveen, additional, Paterson, Euan, additional, Peto, Tunde, additional, Rudnikca, Alicja R., additional, Sattar, Naveed, additional, Self, Jay, additional, Sergouniotis, Panagiotis, additional, Sivaprasad, Sobha, additional, Steel, David, additional, Stratton, Irene, additional, Strouthidis, Nicholas, additional, Sudlow, Cathie, additional, Sun, Zihan, additional, Tapp, Robyn, additional, Thomas, Dhanes, additional, Trucco, Emanuele, additional, Tufail, Adnan, additional, Vitart, Veronique, additional, Viswanathan, Ananth C., additional, Weedon, Mike, additional, Williams, Cathy, additional, Williams, Katie, additional, Woodside, Jayne V., additional, Yates, MaxM., additional, Yip, Jennifer, additional, and Zheng, Yalin, additional

Published
2024
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22. Predicting conversion to wet age-related macular degeneration using deep learning

Author

Yim, Jason, Chopra, Reena, Spitz, Terry, Winkens, Jim, Obika, Annette, Kelly, Christopher, Askham, Harry, Lukic, Marko, Huemer, Josef, Fasler, Katrin, Moraes, Gabriella, Meyer, Clemens, Wilson, Marc, Dixon, Jonathan, Hughes, Cian, Rees, Geraint, Khaw, Peng T., Karthikesalingam, Alan, King, Dominic, Hassabis, Demis, Suleyman, Mustafa, Back, Trevor, Ledsam, Joseph R., Keane, Pearse A., and De Fauw, Jeffrey

Published
2020
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23. Determinants of non-attendance at face-to-face and telemedicine ophthalmic consultations.

Author

Wagner, Siegfried K., Laxmi Raja, Cortina-Borja, Mario, Huemer, Josef, Struyven, Robbert, Keane, Pearse A., Balaskas, Konstantinos, Sim, Dawn A., Thomas, Peter B. M., Rahi, Jugnoo S., Solebo, Ameenat Lola, and Kang, Swan

Abstract

Background/aims Evaluation of telemedicine care models has highlighted its potential for exacerbating healthcare inequalities. This study seeks to identify and characterise factors associated with non-attendance across face-to-face and telemedicine outpatient appointments. Methods A retrospective cohort study at a tertiary-level ophthalmic institution in the UK, between 1 January 2019 and 31 October 2021. Logistic regression modelled non-attendance against sociodemographic, clinical and operational exposure variables for all new patient registrations across five delivery modes: asynchronous, synchronous telephone, synchronous audiovisual and face to face prior to the pandemic and face to face during the pandemic. Results A total of 85 924 patients (median age 55 years, 54.4% female) were newly registered. Non-attendance differed significantly by delivery mode: (9.0% face to face prepandemic, 10.5% face to face during the pandemic, 11.7% asynchronous and 7.8%, synchronous during pandemic). Male sex, greater levels of deprivation, a previously cancelled appointment and not self-reporting ethnicity were strongly associated with non-attendance across all delivery modes. Individuals identifying as black ethnicity had worse attendance in synchronous audiovisual clinics (adjusted OR 4.24, 95% CI 1.59 to 11.28) but not asynchronous. Those not self-reporting their ethnicity were from more deprived backgrounds, had worse broadband access and had significantly higher non-attendance across all modes (all p<0.001). Conclusion Persistent non-attendance among underserved populations attending telemedicine appointments highlights the challenge digital transformation faces for reducing healthcare inequalities. Implementation of new programmes should be accompanied by investigation into the differential health outcomes of vulnerable populations. [ABSTRACT FROM AUTHOR]

Published
2024
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25. Determinants of non-attendance at face-to-face and telemedicine ophthalmic consultations

Author

Wagner, Siegfried K, primary, Raja, Laxmi, additional, Cortina-Borja, Mario, additional, Huemer, Josef, additional, Struyven, Robbert, additional, Keane, Pearse A, additional, Balaskas, Konstantinos, additional, Sim, Dawn A, additional, Thomas, Peter B M, additional, Rahi, Jugnoo S, additional, Solebo, Ameenat Lola, additional, and Kang, Swan, additional

Published
2023
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26. Remote follow-up after cataract surgery (CORE-RCT): study protocol of a randomized controlled trial

Author

Oogheelkunde Onderzoek, MS Oogheelkunde, Brain, Cancer, Infection & Immunity, Claessens, Janneau L.J., Wanten, Joukje C., Bauer, Noël J.C., Nuijts, Rudy M.M.A., Findl, Oliver, Huemer, Josef, Imhof, Saskia M., Wisse, Robert P.L., Oogheelkunde Onderzoek, MS Oogheelkunde, Brain, Cancer, Infection & Immunity, Claessens, Janneau L.J., Wanten, Joukje C., Bauer, Noël J.C., Nuijts, Rudy M.M.A., Findl, Oliver, Huemer, Josef, Imhof, Saskia M., and Wisse, Robert P.L.

Published
2023

27. Diagnostic Accuracy of the Amsler Grid Test for Detecting Neovascular Age-Related Macular Degeneration:A Systematic Review and Meta-analysis

Author

Bjerager, Jakob, Schneider, Miklos, Potapenko, Ivan, Van Dijk, Elon H.C., Faber, Carsten, Grauslund, Jakob, Pfau, Kristina, Huemer, Josef, Muttuvelu, Danson V., Rasmussen, Marie L.R., Sabaner, M. Cem, Subhi, Yousif, Bjerager, Jakob, Schneider, Miklos, Potapenko, Ivan, Van Dijk, Elon H.C., Faber, Carsten, Grauslund, Jakob, Pfau, Kristina, Huemer, Josef, Muttuvelu, Danson V., Rasmussen, Marie L.R., Sabaner, M. Cem, and Subhi, Yousif

Abstract

Importance: Patients with nonneovascular age-related macular degeneration (AMD) are encouraged to use the Amsler grid test for self-assessment to facilitate early diagnosis. The test is widely recommended, suggesting a belief that it signals worsening AMD, warranting its use in home monitoring. Objective: To systematically review studies of the diagnostic test accuracy of the Amsler grid in the diagnosis of neovascular AMD and to perform diagnostic test accuracy meta-analyses. Data Sources: A systematic literature search was conducted in 12 databases for relevant titles from database inception until May 7, 2022. Study Selection: Studies included those with groups defined as having (1) neovascular AMD and (2) either healthy eyes or eyes with nonneovascular AMD. The index test was the Amsler grid. The reference standard was ophthalmic examination. After removal of obviously irrelevant reports, 2 authors (J.B. and M.S.) independently screened the remaining references in full text for potential eligibility. Disagreements were resolved by a third author (Y.S.). Data Extraction and Synthesis: Two authors (J.B. and I.P.) independently extracted all data and evaluated quality and applicability of eligible studies using the Quality Assessment of Diagnostic Accuracy Studies 2. Disagreements were resolved by a third author (Y.S.). Main Outcomes and Measures: Sensitivity and specificity of the Amsler grid for detecting neovascular AMD with comparators being either healthy control participants or patients with nonneovascular AMD. Results: Of 523 records screened, 10 studies were included with a total of 1890 eyes (mean participant age ranging from 62 to 83 years). Sensitivity and specificity to diagnose neovascular AMD were 67% (95% CI, 51%-79%) and 99% (95% CI, 85%-100%), respectively, when comparators were healthy control participants and 71% (95% CI, 60%-80%) and 63% (95% CI, 49%-51%), respectively, when control participants were patients with nonneovascular AMD. Overall

Published
2023

29. Diagnostic Accuracy of the Amsler Grid Test for Detecting Neovascular Age-Related Macular Degeneration

Author

Bjerager, Jakob, primary, Schneider, Miklos, additional, Potapenko, Ivan, additional, van Dijk, Elon H. C., additional, Faber, Carsten, additional, Grauslund, Jakob, additional, Pfau, Kristina, additional, Huemer, Josef, additional, Muttuvelu, Danson V., additional, Rasmussen, Marie L. R., additional, Sabaner, M. Cem, additional, and Subhi, Yousif, additional

Published
2023
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34. The Evolution of Diabetic Retinopathy Screening Programmes: A Chronology of Retinal Photography from 35 mm Slides to Artificial Intelligence

Author

Huemer, Josef, Wagner, Siegfried K, and Sim, Dawn A

Subjects
retina, diabetes, imaging, Review, telemedicine, artificial intelligence, photography
Abstract

As a third of people with diabetes mellitus (DM) will suffer the microvascular complications of diabetic retinopathy (DR) and therapeutic options can effectively prevent visual impairment, systematic screening has substantially reduced disease burden in developed countries. In an effort to tackle the rising incidence of DM, screening programmes have modernized in synchrony with technical and infrastructural advancements. Patient evaluation has shifted from face-to-face ophthalmologist-based review delivered through community grassroots to asynchronous store-and-forward modern telemedicine platforms commissioned on a nationwide scale. First pioneered with primitive 35-mm slide film retinal photography, the last decade has seen an emergence of high resolution and widefield imaging devices, which may reveal extents of DR indiscernible to the clinician but with implications of potential earlier identification. Similar progress has been seen in image analysis approaches – automated image analysis of retinal photographs of DR has evolved from qualitative feature detection to rules-based algorithms to autonomous artificial intelligence-powered classification. Such models have, relatively rapidly, been validated and are now receiving approval from health regulation authorities with deployment into the clinical sphere. In this review, we chart the evolution of global DR screening programmes since their inception highlighting major milestones in healthcare infrastructure, telemedicine approaches and imaging devices that have shaped the robust and effective frameworks recognised today. We also provide an outlook for the future of DR screening in the context of recent technological advancements with respect to their limitations in current times.

Published
2020

39. The Evolution of Diabetic Retinopathy Screening Programmes: A Chronology of Retinal Photography from 35 mm Slides to Artificial Intelligence

Author

Huemer,Josef, Wagner,Siegfried K, Sim,Dawn A, Huemer,Josef, Wagner,Siegfried K, and Sim,Dawn A

Abstract

Josef Huemer,1,2 Siegfried K Wagner,1 Dawn A Sim1 1NIHR Biomedical Research Center at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK; 2Vienna Institute for Research in Ocular Surgery, A Karl Landsteiner Institute, Hanusch Hospital, Vienna, AustriaCorrespondence: Dawn A SimMoorfields Eye Hospital, NHS Foundation Trust, 62 City Road, London EC1V 2PD, United KingdomTel +44 (0)20 7253 3411Email dawnsim@nhs.netAbstract: As a third of people with diabetes mellitus (DM) will suffer the microvascular complications of diabetic retinopathy (DR) and therapeutic options can effectively prevent visual impairment, systematic screening has substantially reduced disease burden in developed countries. In an effort to tackle the rising incidence of DM, screening programmes have modernized in synchrony with technical and infrastructural advancements. Patient evaluation has shifted from face-to-face ophthalmologist-based review delivered through community grassroots to asynchronous store-and-forward modern telemedicine platforms commissioned on a nationwide scale. First pioneered with primitive 35-mm slide film retinal photography, the last decade has seen an emergence of high resolution and widefield imaging devices, which may reveal extents of DR indiscernible to the clinician but with implications of potential earlier identification. Similar progress has been seen in image analysis approaches – automated image analysis of retinal photographs of DR has evolved from qualitative feature detection to rules-based algorithms to autonomous artificial intelligence-powered classification. Such models have, relatively rapidly, been validated and are now receiving approval from health regulation authorities with deployment into the clinical sphere. In this review, we chart the evolution of global DR screening programmes since their inception highlighting major milestones in healthcare infrastructure, telemedicine approaches and imaging dev

Published
2020

40. Insights From Survival Analyses During 12 Years of Anti–Vascular Endothelial Growth Factor Therapy for Neovascular Age-Related Macular Degeneration

Author

Fu, Dun Jack, primary, Keenan, Tiarnan D., additional, Faes, Livia, additional, Lim, Ernest, additional, Wagner, Siegfried K., additional, Moraes, Gabriella, additional, Huemer, Josef, additional, Kern, Christoph, additional, Patel, Praveen J., additional, Balaskas, Konstantinos, additional, Sim, Dawn A., additional, Bunce, Catey, additional, Stratton, Irene, additional, and Keane, Pearse A., additional

Published
2021
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42. A virtual-clinic pathway for patients referred from a national diabetes eye screening programme reduces service demands whilst maintaining quality of care

Author

Faes, Livia, primary, Fu, Dun Jack, additional, Huemer, Josef, additional, Kern, Christoph, additional, Wagner, Siegfried K., additional, Fasolo, Sandro, additional, Hamilton, Robin, additional, Egan, Catherine, additional, Balaskas, Konstantinos, additional, Keane, Pearse A., additional, Bachmann, Lucas M., additional, and Sim, Dawn A., additional

Published
2020
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44. An open-source data set of anti-VEGF therapy in diabetic macular oedema patients over 4 years and their visual acuity outcomes

Author

Kern, Christoph, primary, Fu, Dun Jack, additional, Huemer, Josef, additional, Faes, Livia, additional, Wagner, Siegfried K., additional, Kortuem, Karsten, additional, Patel, Praveen J., additional, Rajendram, Ranjan, additional, Balaskas, Konstantinos, additional, Hamilton, Robin, additional, Sim, Dawn A., additional, and Keane, Pearse A., additional

Published
2020
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45. Widefield optical coherence tomography angiography for early detection and objective evaluation of proliferative diabetic retinopathy

Author

Khalid, Hagar, primary, Schwartz, Roy, additional, Nicholson, Luke, additional, Huemer, Josef, additional, El-Bradey, Mohamed Hosny, additional, Sim, Dawn A, additional, Patel, Praveen J, additional, Balaskas, Konstantinos, additional, Hamilton, Robin D, additional, Keane, Pearse A, additional, and Rajendram, Ranjan, additional

Published
2020
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46. Insights into Systemic Disease through Retinal Imaging-Based Oculomics

Author

Wagner, Siegfried K., primary, Fu, Dun Jack, additional, Faes, Livia, additional, Liu, Xiaoxuan, additional, Huemer, Josef, additional, Khalid, Hagar, additional, Ferraz, Daniel, additional, Korot, Edward, additional, Kelly, Christopher, additional, Balaskas, Konstantinos, additional, Denniston, Alastair K., additional, and Keane, Pearse A., additional

Published
2020
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47. Will AI Replace Ophthalmologists?

Author

Korot, Edward, primary, Wagner, Siegfried K., additional, Faes, Livia, additional, Liu, Xiaoxuan, additional, Huemer, Josef, additional, Ferraz, Daniel, additional, Keane, Pearse A., additional, and Balaskas, Konstantinos, additional

Published
2020
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50. Widefield optical coherence tomography angiography for early detection and objective evaluation of proliferative diabetic retinopathy.

Author

Khalid, Hagar, Schwartz, Roy, Nicholson, Luke, Huemer, Josef, El-Bradey, Mohamed Hosny, Sim, Dawn A., Patel, Praveen J., Balaskas, Konstantinos, Hamilton, Robin D., Keane, Pearse A., and Rajendram, Ranjan

Abstract

Purpose To evaluate the utility of widefield optical coherence tomography angiography (WF-OCTA) compared with clinical examination in grading diabetic retinopathy in patients diagnosed clinically with proliferative diabetic retinopathy (PDR) or severe non-proliferative diabetic retinopathy (NPDR). Design This retrospective observational case series included patients diagnosed clinically with PDR or severe NPDR. Patients underwent standard clinical examination and WF-OCTA imaging (PLEX Elite 9000, Carl Zeiss Meditec AG) using 12Ã--12 montage scans between August 2018 and January 2019. Two trained graders identified neovascularisation at the disc (NVD) and neovascularisation elsewhere (NVE) on WF-OCTA which were compared with the clinical examination, and to ultra-widefield fluorescein angiography (UWFA) when available. Results Seventy-nine eyes of 46 patients were evaluated. Of those, 57 eyes were diagnosed clinically with PDR, and 22 with severe NPDR. NVD was detected on OCTA-B scan as preretinal hyperreflective material (PRHM) in 39 eyes (100%) with evident flow signals in 79.5% compared with 51.3% detected clinically. We further classified NVD on OCTA into four subtypes and found that subtypes 1 and 2 could not be seen on clinical examination alone. WF-OCTA detected NVE in 81% of the cases compared with 55.7% detected clinically. Using WF-OCTA resulted in a higher percentage of PDR grading (88.6%) than on clinical examination (72.2%). When available, UWFA confirmed the WF-OCTA diagnosis in the majority of cases. Conclusion This study demonstrates that WF-OCTA has a higher detection rate of PDR than clinical examination. This suggests that this modality could be used non-invasively for the purpose of early detection and characterisation of neovascularisation. [ABSTRACT FROM AUTHOR]

Published
2021
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