The use of ultra-widefield imaging for the management of diabetic retinopathy

Introduction: Widefield and ultra-widefield (uwf) retinal imaging of diabetic retinopathy can provide information outside that obtained by standard retinal imaging and has the potential to improve the clinical management of diabetic retinopathy.Areas covered: The evidence for clinical benefit of ultra-widefield imaging has been reviewed and put into context in relation to other retinal imaging systems. A medline search was performed using the relevant key words. Several variants of the term ‘ultra widefield’ were searched in relation to diabetic retinopathy imaging as no standard term has been used over time.Expert commentary: Uwf colour and fluorescein angiography combined with optical coherence tomography images, read by a reading centre, provide the most accurate way of assessing the retina. Widefield optical coherence tomography angiography is also becoming available. The use of these technologies can provide better screening, referral refinement, more efficient and accurate clinic assessments and alter management by making it less likely that pathology is missed. Potentially they can lead to alternative treatment approaches, such as retina sparing peripheral laser, but this is yet to be proved. Automated reading of such images is in development.