Systematic Assessment of Clinical Methods to Diagnose and Monitor Diabetic Retinal Neuropathy

Figure 2

Total number of studies for each measure ranked according to strength of evidence. Retinal image processing, retinopathy detection software, and digital fundus photography have been employed most widely in the literature for detecting diabetic changes to the neural retina and are included where they have developed measures of diabetic retinal changes which are reported as preceding standard grades of diabetic retinopathy (such as vessel calibre changes, capillary density in perifoveal intercapillary space, and optic nerve head contour or shape). Unfortunately, they are flawed according to the GRADE criteria of this study in which there are no universal criteria or platform for these modalities in preclinical retinal neuropathy and lack criteria, nor do they indicate current nor future neural retina function.