A Light-emitting Diode(LED)-Based Multispectral Imaging System In Evaluating Diabetic Retinopathy

Background and objectives: Diabetic retinopathy(DR) is the major cause of blindness in adults. It was important and essential to diagnose and treat DR as early as possible. The aim of this study was to describe the characteristics of eyes with DR using a light-emitting diode(LED)-based multispectral imaging(MSI) system and to compare its performance in terms of reliability and diagnostic power with those of fluorescein fundus angiography(FFA), optical coherence tomography(OCT), and fundus photography(FP). Material and methods: In the study, all participants, eyes were evaluated by best-corrected visual acuity(BCVA),slit-lamp, preset lens, MSI, FP, FFA, and OCT. All images were analyzed by three experienced reading center graders and documented by microaneurysm, retinal hemorrhage, hard exudate,cotton wool spots, leakage area, non-perfusion area and diabetic macular edema.The diagnostic power of MSI was evaluated by the area under receiver operating characteristic(ROC) curve(AUC). Results: 76 eyes were included in the study,36 patients were two eyes and 2 patients were monocular. The ROC curve analysis showed that MSI has a high diagnostic value in microaneurysms,exudates, cotton wool spots(AUC=0.951,0.914,0.929; 95%CI0.875~0.988,0.825~0.966,0.844~0.975), a good diagnostic value in retinal hemorrhages(AUC=0.865; 95%CI-0.765~0.933), and has a ability to identify leakage and macular edema(AUC=0.712,0.738; 95%CI 0.595~0.811, 0.622~0.834),and can identify non-perfusion area(AUC=0.633;95%CI 0.513~0.742). MSI can find vascular anomality in short wavelength spectrum images and oxy±deoxy images.Conclusion: This experiment proved that the capacity of MSI in the diagnosis of DR.MSI can recognize the clinical features of DR, especially microaneurysm, retinal hemorrhage, exudate and cotton wool spots, and MSI has the advantages of the noninvasiveness,simplicity, speediness and early phase.