SLO AND OCT-A COMPARISON OF DIABETIC RETINOPATHY EARLY DIAGNOSIS WITH SUPERIMPOSED IMAGE TECHNIQUE
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Abstract
Background: Diabetic retinopathy (DR) is a progressive microvascular complication of diabetes mellitus and remains one of the leading causes of visual impairment globally. Early diagnosis is essential to prevent irreversible vision loss, particularly during the asymptomatic stages of the disease. Traditional imaging techniques are limited in their ability to provide a complete picture of both structural and vascular abnormalities in the retina.
Objective: To evaluate and compare the diagnostic efficacy of Scanning Laser Ophthalmoscopy (SLO) and Optical Coherence Tomography Angiography (OCTA), and to assess the added value of a superimposed image technique in detecting early-stage diabetic retinopathy.
Methods: A cross-sectional study was conducted involving 100 diabetic patients presenting with suspected early-stage DR at Xi’an Jiaotong University Second Affiliated Hospital. All participants underwent SLO and OCTA imaging using standardized protocols. OCTA was employed to detect microvascular abnormalities such as capillary non-perfusion and neovascularization, while SLO identified structural lesions including hemorrhages and exudates. A digital image registration software was used to create superimposed images. Diagnostic accuracy, sensitivity, and specificity were compared using Mann-Whitney U tests, referencing clinical fundus examination and fluorescein angiography (FA) findings.
Results: Superimposed imaging demonstrated higher total lesion detection (mean = 10.2 ± 3.9) compared to SLO alone (8.58 ± 4.27) and OCTA alone (2.00 ± 0.82) (p < 0.01). SLO showed superior detection for hemorrhages (HE) and exudates (EX), while OCTA had greater sensitivity for IRMA and NV lesions. The superimposed technique significantly enhanced lesion localization and diagnostic precision across all lesion types.
Conclusion: The integration of SLO and OCTA through superimposed imaging improves diagnostic accuracy for early-stage diabetic retinopathy, supporting more effective clinical decision-making and timely intervention.
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