With today’s technologies, good imaging techniques often help clinicians more accurately diagnose ocular conditions, even rare ones. Recently, researchers compared ultra-widefield color fundus imaging (UWFI) with dilated fundus examination (DFE) for screening sickle cell retinopathe in children and adults.

The prospective, blinded study included two groups, an adult group (n=268 eyes) and a pediatric group (n=168 eyes). The researchers screened for three types of sickle cell disease:ehemoglobin S homozygous, hemoglobin S and C and hemoglobin S with ß-thalassemia. Three different graders—one clinical grader and two image graders—documented the imaging from UWFI and DFE, based on three clinically relevant diagnostic thresholds. For reference testing, the researchers calculated the sensitivity, specificity and positive and negative predictive values for all three graders based on the thresholds.

The researchers found that most of the advanced sickle cell retinopathy grades were associated with hemoglobin S and C. Of the three graders, image grader one and image grader two consistently detected more SCR and higher SCR grades in both study groups compared with the clinical grader. They also identified twice as many cases of capillary occlusion/anastomosis than the clinical grader. Sensitivity in detecting the presence of proliferative sickle cell retinopathy was also higher among the image graders compared with the clinical grader.

The researchers ultimately concluded that UWFI is a sensitive tool for screening sickle cell retinopathy and is superior to DFE in detecting capillary occlusion or anastomosis.

Alabduljalil T, Cheung C, VandenHoven C, et al. Retinal ultra-wide-field colour imaging versus dilated fundus examination to screen for sickle cell retinopathy. Br J Ophthalmology. August 19, 2020. [Epub ahead of print].