December 2002
Volume 43, Issue 13
Free
ARVO Annual Meeting Abstract  |   December 2002
Efficacy of Digital Diabetic Retinopathy Screening : A Population Based Survey
Author Affiliations & Notes
  • JN Kirkpatrick
    Ophthalmology
    Cheltenham General Hospital Cheltenham United Kingdom
  • P Scanlon
    Ophthalmology
    Cheltenham General Hospital Cheltenham United Kingdom
  • R Malhotra
    Ophthalmology
    Cheltenham General Hospital Cheltenham United Kingdom
  • B Harney
    Cheltenham General Hospital Cheltenham United Kingdom
  • G Thomas
    Cheltenham General Hospital Cheltenham United Kingdom
  • C Foy
    Cheltenham General Hospital Cheltenham United Kingdom
  • N Lewis Barned
    Cheltenham General Hospital Cheltenham United Kingdom
  • Footnotes
    Commercial Relationships   J.N. Kirkpatrick, None; P. Scanlon, None; R. Malhotra, None; B. Harney, None; G. Thomas, None; C. Foy, None; N. Lewis Barned, None.
Investigative Ophthalmology & Visual Science December 2002, Vol.43, 4387. doi:
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    • Get Citation

      JN Kirkpatrick, P Scanlon, R Malhotra, B Harney, G Thomas, C Foy, N Lewis Barned; Efficacy of Digital Diabetic Retinopathy Screening : A Population Based Survey . Invest. Ophthalmol. Vis. Sci. 2002;43(13):4387.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Abstract: : Purpose: To evaluate the effectiveness of digital fundus photography as a method for diagnosis of diabetic retinopathy and for detection of sight threatening retinopathy. Methods: 3611 patients were selected randomly from the diabetic population of Gloucestershire (c 12,000 patients) undergoing systematic retinopathy screening. All patients had digital fundus photography according to the Eurodiab protocol, with and without mydriasis, using a Topcon TRC NW55 camera with a Sony 3-chip video attachment. Of these, 1549 patients underwent simultaneous slit lamp biomicroscopy by an experienced ophthalmologist. All images were graded for presence of diabetic retinopathy using a modified protocol based on the ETDRS grading system by experienced ophthalmologists. Results: With mydriasis sensitivity and specificity for the detection of STDR were 87.2% (CI 82.3 - 92.1%) and 90.1% (CI 88.5 - 91.7%) respectively with a technical failure rate of 4.4%. Absence of mydriasis reduced sensitivity and specificity to 76.5% (CI 70.3-82.7%) and 87.4% (CI 85.6 - 89.2%) respectively with a technical failure rate of 20.7%. Results comparing the grades of retinopathy detected by digital photography with gold standard slit lamp examination showed close agreement for all grades of retinopathy greater than mild NPDR. There was a relative underdiagnosis of normal eyes with digital imaging (50.2% versus 70.3%) and an overdiagnosis of minimal NPDR (14.9% versus 3.6%). Conclusion: Digital fundus photography is a convenient and acceptable method of screening for diabetic retinopathy with an efficacy that compares well to other screening methods. The resolution of digital imaging techniques as used in this study is insufficient to accurately detect minimal diabetic retinopathy.

Keywords: 387 diabetes • 430 imaging/image analysis: clinical • 460 macula/fovea 
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