Publication
ETDRS grading with CLARUS ultra-widefield images shows agreement with 7-fields colour fundus photography
| dc.contributor.author | Santos, Ana Rita | |
| dc.contributor.author | Ghate, Sejal | |
| dc.contributor.author | Lopes, Marta | |
| dc.contributor.author | Rocha, Ana Cláudia | |
| dc.contributor.author | Santos, Torcato | |
| dc.contributor.author | Reste-Ferreira, Débora | |
| dc.contributor.author | Manivannan, Niranchana | |
| dc.contributor.author | Foote, Katharina | |
| dc.contributor.author | Cunha-Vaz, José | |
| dc.contributor.author | Santos, Ana Rita | |
| dc.date.accessioned | 2025-06-18T08:41:55Z | |
| dc.date.available | 2025-06-18T08:41:55Z | |
| dc.date.issued | 2024-09-03 | |
| dc.description.abstract | To analyse and compare the grading of diabetic retinopathy (DR) severity level using standard 35° ETDRS 7-fields photography and CLARUS™ 500 ultra-widefield imaging system. A cross-sectional analysis of retinal images of patients with type 2 diabetes (n=160 eyes) was performed for this study. All patients underwent 7-fields colour fundus photography (CFP) at 35° on a standard Topcon TRC50DX® camera, and ultra-widefield (UWF) imaging at 200° on a CLARUS™ 500 (ZEISS, Dublin, CA, USA) by an automatic montage of two 133° images (nasal and temporal). 35° 7-fields photographs were graded by two graders, according to the Early Treatment Diabetic Retinopathy Study (ETDRS). For CLARUS UWF images, a prototype 7-fields grid was applied using the CLARUS review software, and the same ETDRS grading procedures were performed inside that area only. Grading of DR severity level was compared between these two methods to evaluate the agreement between both imaging techniques. Images of 160 eyes from 83 diabetic patients were considered for analysis. According to the 35° ETDRS 7-fields images, 22 eyes were evaluated as DR severity level 10–20, 64 eyes were evaluated as DR level 35, 41 eyes level 43, 21 eyes level 47, 7 eyes level 53, and 5 eyes level 61. The same DR severity level was achieved with CLARUS 500 UWF images in 92 eyes (57%), showing a perfect agreement (k>0.80) with the 7-fields 35° technique. Fifty-seven eyes (36%) showed a higher DR level with CLARUS UWF images, mostly due to a better visualization of haemorrhages and a higher detection rate of intraretinal microvascular abnormalities (IRMA). Only 11 eyes (7%) showed a lower severity level with the CLARUS UWF system, due to the presence of artifacts or media opacities that precluded the correct evaluation of DR lesions. UWF CLARUS 500 device showed nearly perfect agreement with standard 35° 7-fields images in all ETDRS severity levels. Moreover, CLARUS images showed an increased ability to detect haemorrhages and IRMA helping with finer evaluation of lesions, thus demonstrating that a UWF photograph can be used to grade ETDRS severity level with a better visualization than the standard 7-fields images. | por |
| dc.description.sponsorship | AIBILI through the National NextGeneration EU (Plano de Recuperação e Resiliência - Financiamento Base - Centros de Tecnologia e Inovação - Investimento RE-C05-i02 - Missão Interface nº 03/ C05-i02/2022) and by Carl Zeiss Meditec in the scope of a Clinical Research Agreement with AIBILI and CZM. | |
| dc.identifier.citation | Santos, A. R., Ghate, S., Lopes, M., Rocha, A. C., Santos, T., Reste-Ferreira, D., Manivannan, N., Foote, K., & Cunha-Vaz, J. (2024). ETDRS grading with CLARUS ultra-widefield images shows agreement with 7-fields colour fundus photography. BMC Ophthalmology, 24(1), 387. https://doi.org/10.1186/s12886-024-03537-z | |
| dc.identifier.doi | 10.1186/s12886-024-03537-z | |
| dc.identifier.eissn | 1471-2415 | |
| dc.identifier.uri | http://hdl.handle.net/10400.22/30161 | |
| dc.language.iso | eng | |
| dc.peerreviewed | yes | |
| dc.publisher | BMC | |
| dc.relation.hasversion | https://bmcophthalmol.biomedcentral.com/articles/10.1186/s12886-024-03537-z | |
| dc.rights.uri | http://creativecommons.org/licenses/by/4.0/ | |
| dc.subject | Diabetic retinopathy | |
| dc.subject | Colour fundus photography | |
| dc.subject | Ultra-widefield imaging | |
| dc.subject | CLARUS | |
| dc.subject | ETDRS severity scale | |
| dc.title | ETDRS grading with CLARUS ultra-widefield images shows agreement with 7-fields colour fundus photography | por |
| dc.type | research article | |
| dspace.entity.type | Publication | |
| oaire.citation.endPage | 9 | |
| oaire.citation.startPage | 1 | |
| oaire.citation.title | BMC Ophthalmology | |
| oaire.citation.volume | 24 | |
| oaire.version | http://purl.org/coar/version/c_970fb48d4fbd8a85 | |
| person.familyName | Santos | |
| person.givenName | Ana Rita | |
| person.identifier.ciencia-id | 0911-4138-0C3A | |
| person.identifier.orcid | 0000-0003-0139-0285 | |
| relation.isAuthorOfPublication | d71931b8-d869-4334-993c-ba14ad713f01 | |
| relation.isAuthorOfPublication.latestForDiscovery | d71931b8-d869-4334-993c-ba14ad713f01 |