The reliability of single‐field fundus photography in screening for diabetic retinopathy: the Central Australian Ocular Health Study

Abstract

Single-field digital fundus photography is a valid screening tool for DR in remote communities of central Australia and may be used to provide eye care services to this region with acceptable accuracy.

Systematic review and meta-analysis of diagnostic accuracy of detection of any level of diabetic retinopathy using digital retinal imaging

“…Among 21 studies included in the meta-analysis, 39 different modalities were identified in terms of pupil status, retinal field strategy and human resources involved in index test DR grading. Forty-six percent (18/39 modalities) of the studies used non-mydriatic methods (13/21 studies) [ 25 , 26 , 29 , 31 , 35 , 38 , 40 , 42 , 44 , 45 , 47 – 49 ], 44% (17/39 modalities) used mydriatic methods (11/21 studies) [ 23 – 25 , 32 , 35 , 37 , 39 , 40 , 42 , 44 , 47 ] and ophthalmic personnel currently trained and practiced in DR grading had performed index test grading in these studies. In 10%, 4/21 [ 27 , 28 , 46 , 48 ] newer non-ophthalmologist personnel had performed index test grading.…”

Optometry Australia ‐ Guidelines on the examination and management of patients with diabetes

“…Digital photography has also allowed screening services to reach rural and remote areas via tele‐screening. One recent Australian study demonstrated that single‐field dilated fundus photography in Indigenous Australians meets the minimum screening requirements recommended by the NHMRC, with adequate sensitivities, specificities and repeatability for detecting diabetic retinopathy to determine the need for referral or repeat screening frequencies however, sensitivity of digital photography is influenced by pupil size, media opacities, camera resolution and location of retinopathy outside the posterior pole region …”

Diabetic retinopathy screening: global and local perspective

“…36 Various studies have compared single-field and two-field screening retinal photographs to seven-field stereo photographs. [37][38][39][40] Single-field 45° photographs centred at the fovea, when compared with seven-field photographs, had a sensitivity of 74% to 86% and specificity of 92% to 95%. 37,38 Some other studies have shown high sensitivity and specificity to detect DR using two-field fundus photographs.…”

“…[37][38][39][40] Single-field 45° photographs centred at the fovea, when compared with seven-field photographs, had a sensitivity of 74% to 86% and specificity of 92% to 95%. 37,38 Some other studies have shown high sensitivity and specificity to detect DR using two-field fundus photographs. 39,40 Two-field 45° to 50° photographs consist of images covering the temporal area including the macula and optic disc and the second-field covering the nasal area including the optic disc (Fig 2).…”