Article: Blue Is The Clue To Evaluating Diabetic Retinopathy
Source: Tokyo Medical and Dental University (Japan)
Published: September 6, 2021
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| Concordance of hyporeflective areas in blue widefield scanning laser ophthalmoscope images and non-perfused areas in fluorescein angiography images in proliferative diabetic retinopathy |
In a retrospective study, researchers in Japan examined blue widefield scanning laser ophthalmoscopy (SLO) in the evaluation of non-perfusion areas (ischemia) and retinal thinning in diabetic retinopathy (DR). This method follows earlier imaging techniques using fluorescein angiography (FA) and multicolor widefield SLO, which uses laser light in simultaneous red, green, and blue wavelengths. The researchers found that the blue images captured by conventional SLO could reveal hyporeflective areas in the retina indicative of damage, and sought to explore this finding further in widefield SLO. The retrospective observational case series compared blue widefield SLO with fluorescein angiography in 90 patients with diabetes; in individuals with diabetic retinopathy, retinal morphology was further examined with optical coherence tomography (OCT). The senior author of the study explains, “We found that the hyporeflective areas in the blue widefield SLO images
appeared to correspond with areas of ischemia in the fluorescein
angiogram images of patients with DR. We were pleased to find that the rate of concordance was
high.” Scanning laser ophthalmoscopy, however, is advantageous in that it is non-invasive compared to fluorescein angiography, which uses an intravenous dye. Furthermore, they found that the ischemic areas correspond with retinal thinning. As another researcher comments, “It’s possible that the blue wavelength of light can pass more easily
through these thinned areas of the retina, which present as
hyporeflective areas in the SLO images." Given its non-invasive nature and wider field of view, now enhanced with the detection of ischemia and retinal thinning via the blue wavelength, blue widefield SLO could offer new advantages in the detection and evaluation of diabetic retinopathy.
My rating of this study: ⭐⭐
Shintaro H, Nobuyuki K, Koju K, et al. "Blue Widefield Images of Scanning Laser Ophthalmoscope Can Detect Retinal Ischemic Areas in Eyes With Diabetic Retinopathy." Asian-Pacific Journal of Ophthalmology. 10(5):478-485. September-October 2021. 10.1097/APO.0000000000000432
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