Scanning laser ophthalmoscopy (SLO) can help detect microaneurysms, blot hemorrhages and cotton-wool spots as good as any color fundus photo, according to a newly published study in the Acta Ophthalmologica journal.

The research compared images derived from SLO technology with color fundus photos of 67 dilated eyes, all of which had varying degrees of diabetic retinopathy. The researchers cropped the SLO images to match the size and position of their 45-degree color fundus photograph equivalent. Five independent, masked graders assessed the images looking for telltale signs of diabetic retinopathy, including hemorrhages, microaneurysms and cotton-wool spots, as well as intraretinal microvascular abnormalities, exudates, venous beading and neovascularization. The images were classified in accordance with the Early Treatment of Diabetic Retinopathy Study grading and English Diabetic Eye Screening Program.

The researchers identified inter-grader variability in flame hemorrhage, intraretinal microvascular abnormalities, venous beading and neovascularization grading between the two modalities. But the average number of microaneurysms for SLO and color photos showed a high degree of agreement, as did the average number of blot hemorrhages and the average number of cotton-wool spots found. For these three lesions, the inter-grader reliability was good across both modalities, the report says.

Nghiem A, Nderitu P, Lukic M, et al. Comparing diabetic retinopathy lesions in scanning laser ophthalmoscopy and colour fundus photography. Acta Ophthalmol. July 8, 2019. [Epub ahead of print].