A new imaging technique using video recording to assess the health of the retina is expected to boost early detection of diabetic eye disease.
Some 300,000 Australians are already affected by diabetic retinopathy, which can lead to serious vision loss and blindness. As the obesity epidemic drives a diabetes epidemic, the need for accessible and effective screening is becoming even more important.
Dr Daniel Ting, a PhD research candidate of the University of Western Australia and Australian E-Health Research Centre, told the Asia Pacific Academy of Ophthalmology (APAO) Congress that retinal video recording provided results comparable to the established techniques, as well as additional advantages.
“We’ve screened 200 eyes at the Royal Perth Hospital and found that retinal video recording was as accurate as still photography and slit lamp examination in detecting the clinical signs of diabetic retinopathy,” he said.
About a third of the participants in the study were found to have some evidence of diabetic retinopathy – swelling of the retinal blood vessels, leakage of fluid/blood into the surrounding tissue and formation of abnormal new blood vessels which are fragile and prone to bleeding. If left untreated, they often lead to severe visual impairment in people with diabetes.
“Slit lamp examinations are the gold standard for detecting retinal changes but the technique is typically performed by a specialist ophthalmologist and there are long waiting lists involved,” explained Dr Ting.
“Retinal still photography has become the default procedure for screening in many places as the images can be taken by a well trained operator and reviewed by a specialist at a later time,” he added.
The retinal video recording may be a novel alternative to the current techniques to screen for people with diabetes.
“It is able to image a larger area of retina within a shorter period of time, compared to the conventional retinal still photography,” said Dr Ting. “It also provides a good continuity of retinal information and is less dependent on the cooperation of the patients who may move or lose focus during the process of still photography.”
While the study has only tested video recording in a hospital clinic setting, Dr Ting said it could be potentially suited to telemedicine applications for regional, rural and remote communities.
“We found this following a further study which showed that the retinal videos could be significantly compressed without losing diagnostic accuracy,” he added. “However, more research will be required to evaluate the clinical and cost-effectiveness of implementing video screening in a tele-ophthalmology setting.”
Dr Ting said primary healthcare providers such as GPs or Aboriginal health workers could become more involved in the screening process with only a few hours of training on how to use the camera and take good videos.
The video camera was developed at the Lions Eye Institute (Western Australia) by Professor Yogesan Kanagasingam who has recently been appointed as the research director for Australian E-Health Research Centre (AEHRC)/Commonwealth Scientific Industrial Research Organization (CSIRO). He is also the president of the Australasian TeleHealth Society.
This research project has been funded by the Diabetes Australia Research Trust and Royal Perth Hospital Medical Research Foundation.