The Use of Optical Coherence Tomography for the Detection of Early Diabetic Retinopathy

Abstract

Diabetic retinopathy (DR) is one of the leading causes of vision loss globally with a severe burden on all societies due to its high treatment and rehabilitation costs. The early diagnosis of DR may provide preventive steps (including retinal laser therapy and tight carbohydrate, blood pressure, and cholesterol control) that could in turn help to avoid progression of the pathology with the resultant vision loss. Optical coherence tomography (OCT) enables the in vivo structural imaging of the retina, providing both qualitative (structure) and quantitative (thickness) information. In the past decades, extensive OCT research has been done in the field of DR. In the present review, we are focusing on those that were aiming at detection of the earliest retinal changes before DR could be diagnosed funduscopically. The latest, widely available technology of spectral-domain (SD-)OCT comes with a fast and reliable retinal imaging, which, together with the most recent developments in image processing and artificial intelligence, holds the promise of developing a quick and efficient, state-of-the-art screening tool for DR.

Zusammenfassung

Diabetische Retinopathie (DR) ist eine der führenden Ursachen des Sehverlustes weltweit und stellt wegen der hohen Behandlungs- und Rehabilitationskosten eine hohe Belastung für alle Gesellschaftsebenen dar. Durch eine früh gestellte Diagnose der DR kann die Feineinstellung von Blutzucker, Blutdruck und Cholesterin erzielt und eine frühzeitige Laserbehandlung der Netzhaut durchgeführt werden, welche die Progression und den dadurch auftretenden Sehverlust vermeiden. Die optische Kohärenztomografie (OCT) ist ein bildgebendes Verfahren, mit welchem die Netzhautstruktur in vivo dargestellt werden kann und das wichtige qualitative (Struktur) und quantitative (Dicke) Informationen über die Netzhaut liefert. In der letzten Zeit wurde Vieles im Bereich der OCT-Diagnostik von diabetischer Retinopathie erforscht. In unserem Review wollen wir uns auf die frühestmögliche Diagnosestellung mithilfe der OCT-Technologie fokussieren. Die neueste, auf dem Markt weitgehend erhältliche Spektral-Domänen-OCT-Technologie (SD-OCT) bietet ein schnelles und genaues Imaging der Netzhaut, das zusammen mit den neuesten Entwicklungen im Bereich Bildbearbeitung und künstlicher Intelligenz sehr vielversprechend in Bezug auf ein schnelles und effizientes Screening der frühen diabetischen Retinopathie ist.

Key words

diabetes - diabetic retinopathy - optical coherence tomography - image processing - deep learning - screening

Schlüsselwörter

Netzhaut - Aderhaut - Glaskörper

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