Bakgrund: Alla diabetiker erbjuds screening av ögonbottnen för diabetesretinopati så att den ska kunna upptäckas och behandlas i tid. Enligt Region Skånes riktlinje för screening av diabetesretinopati kan en traditionell funduskamera eller en wide field ka-mera som täcker 80 procent av näthinnan användas, något som hittills enbart Optos kan. Syftet med studien var att undersöka hälso- och sjukvårdspersonalens uppfattningar om Optos i samband med screening av diabetesretinopati. Metod: Femton ögonmottagningar visade sig använda Optos. Av dessa deltog tio i tvär-snittsenkätstudien. En webbenkät utformades bestående av öppna och multiple-choice frågor. Fritextsvaren analyserades med innehållsanalys som resulterade i ett antal kategorier och respektive svarsfrekvenser. Resultat: Optos uppfattades som en användar- och patientvänlig metod vilken kan öka tillgängligheten. Skärpan i Optomap uppfattades vara god, men något sämre än i fun-dusbilderna. Några uppfattade Optos som en bra metod för screening av diabetesretino-pati. Andra ansåg att användning av Optos skulle innebära en patientrisk. Då den sämre centrala skärpan skulle kunna leda till underdiagnosticering alternativt att Optomaps stora täckningsgrad skulle kunna vara anledning till en överdiagnosticering. Ett stort externt bortfall begränsar studieresultatets generaliserbarhet. Slutsats: Uppfattningar huruvida Optos anses vara lämpligt att användas i samband med screening av diabetesretinopati går isär och lämpliga användningsområden behöver definieras närmare. / Background: Screening for retinopathy is offered to all diabetics to allow detection and treatment on time. According to a regional guideline for screening of diabetic retino-pathy traditional fundus camera may be used or a wide field camera picturing 80 % of the retina, something nowadays only Optos can do. Aim of this study was to investigate health personnel’s attitude towards Optos in the context of diabetic retinopathy screening. Methods: Fifteen eye clinics using Optos were identified and ten of those took part in this survey. Self-administered questionnaires with multiple-choice and open questions were used. Free text answers were analysed using context analysis with determination of frequencies for the evolving categories. Results: Optos was perceived as being user and patient friendly, as well as being able to increase accessibility. Optomap had good but digital fundus pictures better perceived acuity. According to some was Optos a good method for screening of diabetic retino-pathy and inappropriate according to others apprehending a patient risk. Expecting underdiagnosis due to less central acuity alternatively overdiagnosis due to Optomap covering 80 % of the retina. High drop-out rate eventuates limited validity. Conclusions: Diverging attitudes emerged whether Optos is suitable for screening of diabetic retinopathy. Its appropriate use needs to be defined in further detail.

Purpose: The purpose of this study was to compare corneal thickness measured both centrally and midperipherally, between two instruments using different measuring principles. The study also looked at correlation between corneal thickness and intraocular pressure (IOP). Methods: Central and midperipheral corneal thickness was measured on the right eyes of 31 subjects with two different instruments. Instruments were Scheimpflug-camera from Bon Sirius and an AS/OCT from Optos. Measurements were taken on central cornea (CCT) and midperipheral (nasal (NCT), temporal (TCT), superior (SCT) and inferior (ICT)) at a distance of 1.75 mm from the apex. Mean age of the subjects was 23.6 ± 4.5 years. (19-44 years). A CT-80A non-contact tonometer (NonCT) from Topcon was used to measure the intraocular pressure (IOP). Results: A mean-value for central corneal thickness was calculated to 542.4 µm and 540.4 µm for Bon Sirius and AS/OCT repectively. Remaining measured points had mean-values for corneal thickness of, NCT: 577.7 µm & 558.5 µm. TCT: 555.0 µm & 545.2 µm. SCT: 585.7 µm & 554.5 µm. ICT: 563.0 µm & 548.9 µm, respectively. Mean-difference for CCT was 2.4 µm and it showed a significant difference between the two instruments with a p-value of 0.007. Remaining measured points all showed a significant difference of p<0.05. NCT: 19.2 µm. TCT: 9.8 µm. SCT: 31 µm. ICT: 14 µm. A correlation between IOP and CCT measured in both Sirius and AS/OCT was positive with r = 0.7 and p<0.05. Conclusion: The results showed that Sirius gives higher values for corneal thickness then ASOCT in all five measurement points. The results show that these instruments can be used interchangeably when measuring central corneal thickness. However, caution should be used when measuring midperipheral corneal thickness as the there is a significant differences between these two instruments.

Diabetic retinopathy (DR) and diabetic macular edema (DME) are among the leading causes of vision loss worldwide. Early detection and timely intervention are crucial in decreasing the risk of vision impairment worldwide. Optical Coherence Tomography Angiography (OCTA) is an emerging imaging modality that has advantages to the current standard for assessing retinal microvascular changes in diabetic eye diseases. This study aims to evaluate the cost-effectiveness of different screening strategies incorporating OCTA for the detection and management of DR and DME. A decision tree model (Figure 2) was created to estimate the cost consequences of different screening strategies for clinically significant macular edema (CSME) and severe DR in the United States. The model can be used to compare two screening arms: A) standard fluorescein angiography (FA) and optical coherence tomography (OCT) scans with standard of care follow-up.; and B) Universal OCTA imaging with FA and OCT scans with standard of care follow-up. In both strategies, screening will start with the most sensitive imaging (OCTA > OCT > FA) that is available. Strategy A will serve as the control with the current standard image screening protocol for DME and DR diagnosis, which is based on the National Institute of Clinical Excellence (NICE) guidelines used in both the U.S. and U.K. These guidelines include FA imaging and a visual acuity test within 3 months of diagnosis of diabetes. In accordance with the guidelines, if DR or CSME is identified the participant will subsequently be referred to an ophthalmologist at which point OCT will also be obtained at this visit. If no DR or CSME is identified during imaging, the guidelines state that follow-up imaging should be conducted every 6 months. Strategy B will involve universal OCTA Imaging, FA imaging, OCT scans and a visual acuity test. Screening with OCTA imaging should be conducted before proceeding to screen the FA images taken. If criteria for CSME or severe DR is met, then the participant will be referred to an ophthalmologist. If criteria for CSME or severe DR is not met, then the participant will receive follow up imaging every 6 months.