Screening of diabetic retinopathy: Effect of field number and mydriasis on sensitivity and specificity of digital fundus photography

Aptel, Florent; Denis, P.; Rouberol, F.; Thivolet, C.

doi:10.1016/j.diabet.2007.12.007

Cited by 80 publications

(60 citation statements)

References 12 publications

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“…We found fair agreement between the results of the fundus photographs and the ophthalmologist examination (κ = 0.48), as in other studies [10,32]. The rate of unreadable photographs (13.3%) was similar to that found by Cavallerano et al [33 ](13%) and higher than for Gomez-Ulla et al [34] (5%).…”

Section: Discussionsupporting

confidence: 69%

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Effectiveness of a Mobile Diabetic Retinopathy Screening Campaign to Encourage Diabetics to Undergo Regular Ophthalmic Follow-Up

Creuzot‐Garcher

Martin-Phipps²,

Beynat³

et al. 2014

Ophthalmic Res

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Aim: To evaluate the effectiveness of a mobile diabetic retinopathy (DR) screening campaign with a non-mydriatic camera to encourage diabetics to undergo a subsequent ophthalmic follow-up. Methods: Diabetic patients who underwent free DR screening with a non-mydriatic fundus camera were given the recommendation to have an ophthalmic visit, in a time frame suited to the DR stage or in case abnormalities in the macula, the optic nerve or intra-ocular pressure were detected. The photographs were performed by a trained orthoptist. The date of the visit to their ophthalmologist and the report of this consultation were recorded. Results: During 5 annual campaigns, 4,699 diabetics were screened. Of the 1,573 ophthalmic examinations recommended at the screening, 1,241 (79%) were actually conducted. A total of 623 new cases of DR were found in the course of this screening campaign, with a fair concordance between the diagnosis suggested at screening and the examination by the ophthalmologist (κ = 0.48). Conclusion: Information and recommendations given during DR screening helped to reintroduce patients to a regular ophthalmic follow-up, at least in the short term.

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Section: Discussionsupporting

confidence: 69%

“…Furthermore, many authors consider fundus photographs with a non-mydriatic camera as an effective and reliable screening method for DR, with both good sensitivity and specificity [9,10,11]. It allows documentation of the fundus without pupil dilatation, with a trained technician [12].…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of a Mobile Diabetic Retinopathy Screening Campaign to Encourage Diabetics to Undergo Regular Ophthalmic Follow-Up

Creuzot‐Garcher

Martin-Phipps²,

Beynat³

et al. 2014

Ophthalmic Res

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“…The photographer took three images per eye: 1) posterior pole centered on the macula corresponding to Early Treatment Diabetic Retinopathy Study (ETDRS) photo area 1; 2) nasal field, corresponding to ETDRS photo area 2; and 3) superotemporal field, corresponding to ETDRS photo area 4. [12,13] Images were repeated as necessary until the photographer was satisfied with the image quality. Study participants underwent 45° non-mydriatic fundus photography with the Smartscope followed by mydriatic Smartscope and mydriatic tabletop fundus camera (Topcon TRC–50DX, Tokyo, Japan) photography.…”

Section: Methodsmentioning

confidence: 99%

Predictors of Photographic Quality with a Handheld Nonmydriatic Fundus Camera Used for Screening of Vision-Threatening Diabetic Retinopathy

et al. 2017

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Purpose: To analyze predictors of image quality for a handheld nonmydriatic fundus camera used for screening of vision-threatening diabetic retinopathy. Methods: An ophthalmic photographer at an Aravind Eye Hospital obtained nonmydriatic and mydriatic fundus images from 3 fields in 275 eyes of 155 participants over 13 months using a Smartscope camera (Optomed, Oulu, Finland) and a Topcon tabletop fundus camera (Topcon, Tokyo, Japan). Two fellowship-trained retina specialists graded the images. Repeated-measures logistic regression assessed predictors of the main outcome measure: gradability of the fundus images. Results: Of 2,475 images, 76.2% of the Smartscope nonmydriatic images, 90.1% of the Smartscope mydriatic images, and 92.0% of the Topcon mydriatic images were gradable. Eyes with vitreous hemorrhage (OR = 0.24, p < 0.0001) or advanced cataract (OR = 0.08, p < 0.0001) had decreased odds of image gradability. Excluding eyes with cataract or vitreous hemorrhage, nonmydriatic macular image gradability improved from 68.4% in the first set of 55 eyes to 94.6% in the final set of 55 eyes. Conclusion: With sufficient training, paraprofessional health care staff can obtain high-quality images with a portable nonmydriatic fundus camera, particularly in patients with clear lenses and clear ocular media.

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“…Pugh et al [13] reported that 42 of 50 ungradable photographs became gradable after dilation. On the other hand, some studies suggest that mydriasis did not significantly influence image grading [14,15]. In our study, 10.7% of our patients were dilated.…”

Section: Discussionmentioning

confidence: 56%

“…Non-mydriatic 45-degree digital fundus photography has compared favorably with ophthalmoscopy [12,13]. The sensitivity and specificity for detecting sight-threatening DR using a single non-mydriatic 45-degree digital fundus photograph has been reported to range from 61 to 77% and 85 to 99%, respectively [11][12][13][14][15][16]. Ophthalmoscopy suffers from a low sensitivity even when performed by ophthalmologists [11].…”

Section: Discussionmentioning

confidence: 97%

Diabetic retinopathy screening using single-field digital fundus photography at a district level in Costa Rica: a pilot study

Martínez¹,

Hernández-Bogantes

2011

Int Ophthalmol

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To report on our initial experience screening for diabetic retinopathy (DR) using digital fundus photography and standarized criteria. Cross-sectional prospective study of all 1327 diabetic patients referred to the Ophthalmology Department of the Clorito Picado Clinic in San José, Costa Rica between April 2008 and March 2009. Patients were screened with a single-field 45-degree digital color retinal image centered on the fovea. The main outcome measures were prevalence of DR, waiting time for a fundus photograph appointment and the number of patients that needed to be evaluated by an ophthalmologist. In this population of 1327 patients, 85% did not have any retinopathy. The prevalence of DR was 15%. Mild non-proliferative DR (NPDR) was seen in 5.8% (70/1215), moderate NPDR in 3.9% (47/1215), severe NPDR in 4.7% (57/1215) and proliferative DR in 0.6% (8/1215). Macular edema was present in 2.6% (32) patients. 13.8% of patients required pupillary dilation for an adequate image to be taken and 8.8% of the images were unreadable. The average waiting time for a fundus photograph appointment was 49.1 days. A total of 13.8% (183/1327) patients were referred to the ophthalmologist. Of these referrals, 61.2% (112/183) were because of unreadable images and 38.8% (71/183) were referred for further ophthalmic treatment. Digital fundus photographic screening for DR appears to be a viable option for the improvement of screening for DR in Costa Rica.

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Screening of diabetic retinopathy: Effect of field number and mydriasis on sensitivity and specificity of digital fundus photography

Cited by 80 publications

References 12 publications

Effectiveness of a Mobile Diabetic Retinopathy Screening Campaign to Encourage Diabetics to Undergo Regular Ophthalmic Follow-Up

Effectiveness of a Mobile Diabetic Retinopathy Screening Campaign to Encourage Diabetics to Undergo Regular Ophthalmic Follow-Up

Predictors of Photographic Quality with a Handheld Nonmydriatic Fundus Camera Used for Screening of Vision-Threatening Diabetic Retinopathy

Diabetic retinopathy screening using single-field digital fundus photography at a district level in Costa Rica: a pilot study

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