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Salvador Lopez-Rubio, David Rivera, Liliana Perez-Peralta, Aida Jimenez-Corona, Sergio Hernández-Jiménez, Carlos A Aguilar-Salinas, Enrique O Graue; Non-mydriatic fundus photography vs. clinical ophthalmoscopy for diabetic retinopathy in patients with early diabetes diagnosis. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):1406.
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To compare diabetic retinopathy (DR) diagnosis with non-mydriatic camera versus clinical examination in patients with recent diagnosed type 2 diabetes.
A prospective, comparative study was conducted at the Diabetic Patient Comprehensive Care Center in Mexico City. Patients aged 18-70 years with type 2 diabetes and less than 5 years of diagnosis were included. Active smoking patients were excluded. All eyes underwent a complete ophthalmic examination. One eye (non-dilated) was examined with 3-Field 450 color fundus photographs: field 1, macula center; field 2, optic nerve center; and field 3, temporal to macula center. A retina specialist performed a complete dilated fundus exam with slit lamp and a 90D lens of the other eye. The proportion of eyes diagnosed with color fundus photographs was compared with that of eyes diagnosed with ophthalmoscopy using Chi-square test. All analyses were performed using SPSS.
160 eyes of 80 consecutive patients were included. Of the eyes examined with non-mydriatic camera, 14 were diagnosed with diabetic retinopathy (prevalence 17.5%; 95%CI 10.5-27.3). Of the eyes examined with pupil dilated and ophthalmoscopy, 16 had diabetic retinopathy (prevalence 20%; 95%CI 12.6-30.1). No statistically significant difference was found between both groups (p = 0.83).
Since mydriatic clinical examination detects diabetic retinopathy in the peripheral retina, where the non-mydriatic camera cannot reach, more cases of diabetic retinopathy can be detected with clinical exam. In this series of patients, however, we couldn't find any significant difference between the two methods, so it seems that non-mydriatic camera examination is enough to screen patients with diabetes. We thus conclude that the non-mydriatic camera is sufficient as a diagnostic tool for diabetic retinopathy in this population.
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