Use of High Resolution Digital Retinal Imaging in the Early Detection of Retinopathy in Type 1 Diabetes

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Authors

  • Nicole Mendez Rutgers New Jersey Medical School, 90 Bergen Street, PO Box 1709, Newark, NJ 07103, USA
  • Sumana Kommana Rutgers New Jersey Medical School, 90 Bergen Street, PO Box 1709, Newark, NJ 07103, USA
  • Lesley Wu Rutgers New Jersey Medical School, 90 Bergen Street, PO Box 1709, Newark, NJ 07103, USA
  • Pooja Padgaonkar Rutgers New Jersey Medical School, 90 Bergen Street, PO Box 1709, Newark, NJ 07103, USA
  • Ben Szirth Director, Tele-Ocular Program, Institute of Ophthalmology and Visual Science, Doctors Office Center, Suite 600, Rutgers, The State University of New Jersey, New Jersey Medical School, 90 Bergen Street, Newark, NJ 07103, USA
  • Albert S. Khouri Program Director, Ophthalmology Residency, Associate Director, Glaucoma Division, Rutgers New Jersey Medical School, 90 Bergen Street, PO Box 1709, Newark, NJ 07103, USA

DOI:

https://doi.org/10.17140/DROJ-1-114

Keywords:

Retinopathy, Microaneurysms, Type 1 diabetes, Cataract

Abstract

Background: Type 1 Diabetes Mellitus is one of the most common endocrine and metabolic conditions worldwide, affecting nearly half a million children under the age of 15 years with an anticipated rise in incidence of 4%. The ocular complications of type 1 diabetes can be blinding and thus, inflicting catastrophic consequences on quality of life. In this disease, the greatest
impact in the prevention of vision loss comes from early detection and treatment. Methods: Retinal screening was performed to capture both right and left eyes of children as young as 5 years of age. A Canon CR-2 Plus AF (Tokyo, Japan) non-mydriatic retinal camera with a CMOS chip, a resolution of 18 megapixel and an ISO setting of 400 (range available is from 200 to 6400 ISO) in sensitivity was used for these images. Image management used was image SPECTRUM V5 (Canon USA, Irvine, CA), a postcapture imaging software that automatically separated a color image into three (3) monochromatic images; namely blue, green and
red, to help visualize the nerve fiber layer, the retinal layers as well as the choroid, respectively. Results: In subjects with positive findings (mild diabetic retinopathy), retinal pathology was noted on digital imaging and involved retinal hemorrhages and vascular changes consistent with microaneurysms. Severe nonproliferative diabetic retinopathy was detected in one 20-year-old subject. One subject presented with cataract. Subjects with a positive finding were counseled and a referral to an ophthalmologist was recommended. Conclusions: Non-mydriatic retinal imaging used in mass screenings can help identify the early retinal changes and advance the management and care of patients with diabetic retinopathy. Improvements in digital imaging software and the ability to perform telemedicine from remote locations, can aid eye health care providers in the detection and isolation associated with various
levels of retinopathy.

References

International Diabetes Federation. Diabetes Atlas, 5th ed. IDF. Brussels, Belgium, 2011.

Tuomilehto J, Virtala E, Karvonen M, et al. Increase in in-cidence of insulin-dependent diabetes mellitus among children in Finland. Int J Epidemiol. 1995; 24: 984-992. doi: 10.1093/ ije/24.5.984

Gardner SG, Bingley PJ, Sawtell PA, et al. Rising inci-dence of insulin dependent diabetes in children aged under 5 years in the Oxford region: time trend analysis. The Bart’s Oxford Study Group. BMJ. 1997; 315: 713-717. doi: 10.1136/ bmj.315.7110.713

Dahlquist G, Mustonen L. Analysis of 20 years of prospective registration of childhood onset diabetes time trends and birth cohort effects. Swedish Childhood Diabetes Study Group. Acta Paediatr. 2000; 89: 1231-1237. doi: 10.1111/j.1651-2227.2000. tb00741.x

Guariguata L. Estimating the worldwide burden of type 1 dia-betes. International Diabetes Federation. 2011; 6-8.

International Diabetes Federation. Diabetes Atlas, 3rd ed. IDF. Brussels, Belgium, 2007.

Elamin A, Altahir H, Ismail B, Tuvemo T. Clinical pattern of childhood type 1 (insulin-dependent) diabetes mellitus in the Sudan. Diabetologia. 1992; 35: 645-648.

Nishimura R, LaPorte RE, Dorman JS, et al. Mortality Trends in Type 1 Diabetes: The Allegheny County (Pennsylvania) Registry 1965-1999. Diabetes Care. 2001; 24: 823-827. doi: 10.2337/diacare.24.5.823

Harding SP, Broadbent DM, Neoh C, White MC, Vora J. Sen-sitivity and specificity of photography and direct ophthalmosco-py in screening for sight threatening eye disease: the Liverpool Diabetic Eye Study. BMJ. 1995; 311(7013): 1131-1135.

Griffith, SP, Freeman WL, Shaw CJ, et al. Screening for diabetic retinopathy in a clinical setting: a comparison of direct ophthalmoscopy by primary care physicians with fundus pho-tography. J FamPract. 1993; 37(1): 49-56.

Lin DY, Blumenkranz MS, Brothers RJ, Grosvenor DM. The sensitivity and specificity of single-field nonmydriatic mono-chromatic digital fundus photography with remote image inter-pretation for diabetic retinopathy screening: a comparison with ophthalmoscopy and standardized mydriatic color photography. Am J Ophthalmol. 2002; 134(2): 204-213. doi: 10.1016/S0002- 9394(02)01522-2

American Academy of Ophthalmology Preferred Practice Patterns Committee. Preferred Practice Pattern® Guidelines. Di-abetic Retinopathy. San Francisco, CA, USA: American Acad-emy of Ophthalmology. Available from: www.aao.org/ppp 2014.

American Optometric Association. Eye Care of the Patient with Diabetes Mellitus. St. Louis, MO, USA: 2014 American Optometric Association. Available from: http://www.aoa.org/ Documents/EBO/EyeCareOfThePatientWithDiabetesMelli-tus%20CPG3.pdf

American Diabetes Association. Standards of medical care in diabetes-2013. Diabetes Care. 2013: 36(Suppl 1): S11-S66. Available from: http://care.diabetesjournals.org/content/26/sup-pl_1/s99/T1.expansion.html

Published

2015-08-18

How to Cite

Nicole Mendez, Sumana Kommana, Lesley Wu, Pooja Padgaonkar, Ben Szirth, & Albert S. Khouri. (2015). Use of High Resolution Digital Retinal Imaging in the Early Detection of Retinopathy in Type 1 Diabetes. Diabetes Research, 1(4), 79–83. https://doi.org/10.17140/DROJ-1-114

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