ArticleOphthalmology science2021
Comparison of Ultra-Widefield Imaging and Standard Imaging in Assessment of Early Treatment Diabetic Retinopathy Severity Scale.
Article in Ophthalmology science, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 1 of them a synthesis that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
15 citing papers in PubMed, 1 synthesis or guideline pooled it, 19 citations in OpenAlex.
- Comparative diagnostic accuracy of photographic methods for detecting diabetic retinopathy: A systematic review and meta-analysis.European journal of ophthalmology · 2026Pooled it
- Influence of ocular biometry on peripheral retinal visualization: a comparative study of Clarus and Optos widefield imaging systems.BMC ophthalmology · 2026Article
- Impact of teleretinal screening program on diabetic retinopathy screening compliance rates in community health centers: a quasi-experimental study.BMC health services research · 2025Article
- The novel antidiabetic medications on diabetic retinopathy: relevant molecular mechanisms, advancing diagnostic innovations, and therapeutic implications.Frontiers in medicine · 2025Review
- Microvascular Metrics on Diabetic Retinopathy Severity: Analysis of Diabetic Eye Images from Real-World Data.Biomedicines · 2024Article
- Intraretinal Microvascular Abnormalities in Eyes with Advanced Stages of Nonproliferative Diabetic Retinopathy: Comparison Between UWF-FFA, CFP, and OCTA-The RICHARD Study.Ophthalmology and therapy · 2024Article
- Distribution of Microaneurysms and Hemorrhages in Accordance with the Grading of Diabetic Retinopathy in Type Diabetes Patients.Diagnostics (Basel, Switzerland) · 2024Article
- Wide-field imaging with smartphone based fundus camera: grading of severity of diabetic retinopathy and locating peripheral lesions in diabetic retinopathy.Eye (London, England) · 2024Article
- The Diabetic Retinopathy "Pandemic" and Evolving Global Strategies: The 2023 Friedenwald Lecture.Investigative ophthalmology & visual science · 2023Article
- Comparison of diabetic retinopathy severity grading on ETDRS 7-field versus ultrawide-field assessment.Eye (London, England) · 2023Article
- Discriminative-Region Multi-Label Classification of Ultra-Widefield Fundus Images.Bioengineering (Basel, Switzerland) · 2023Article
- Peripheral retinal vessel whitening in patients with diabetes mellitus.Scientific reports · 2023Article
- Progression of Capillary Hypoperfusion in Advanced Stages of Nonproliferative Diabetic Retinopathy: 6-month Analysis of RICHARD Study.Ophthalmology scienceArticle
- Comparison of Standard 7-Field, Clarus, and Optos Ultrawidefield Imaging Systems for Diabetic Retinopathy (COCO Study).Ophthalmology scienceArticle
- Imaging Modalities for Assessing the Vascular Component of Diabetic Retinal Disease: Review and Consensus for an Updated Staging System.Ophthalmology scienceArticle
Corrections and comments
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Authors and funding
4 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Purpose: To compare Early Treatment Diabetic Retinopathy Study (ETDRS) severity levels between standard 7-field imaging and ultra-widefield (UWF) imaging and to incorporate peripheral diabetic retinopathy (DR) lesions into the ETDRS grading system. Design: Cross-sectional Study. Participants: Paired images from 192 eyes (189 participants) with diabetic retinopathy were included. Methods: The ETDRS levels were determined by masked graders in 3 ways: standard 7-field imaging, UWF within the 7-field region (7-field UWF imaging), and the entire UWF image (global ETDRS imaging). Main Outcome Measures: Percentage agreement between 7-field and UWF imaging for ETDRS levels. Results: Of the 166 paired images evaluated, exact agreement was found in 48.8% of eyes between standard 7-field and 7-field UWF ETDRS levels with a weighted κ value of 0.59 (95% confidence interval [CI], 0.5-0.68). Agreement rates varied with DR severity and were least in early DR (30.8%) and moderate nonproliferative DR (26.5%) groups. In 156 eyes with 7-field UWF ETDRS and global UWF ETDRS levels, exact agreement was found in 143 eyes (92%), with a weighted κ value of 0.9 (95% CI, 0.9-0.98). The peripheral lesions contributed to a higher DR severity in 8% and changed the eye to a proliferative DR level in 2%. Reproducibility of the 3 ETDRS evaluations was comparable with a weighted κ value of 0.57 with standard 7-field imaging, 0.65 with 7-field UWF imaging, and 0.60 with global ETDRS scale imaging. Conclusions: Moderate agreement was found in the ETDRS DR severity scale between standard 7-field and UWF imaging, indicating caution in interchanging data from the 2 methods. Both methods showed good reproducibility for clinical trial outcome of 2-step change. The global ETDRS scale provides a comprehensive score to incorporate peripheral changes into the ETDRS scale. The implications of the global scale on progression rate are yet to be determined.
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