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I. Tran, F. Nguyen, N. Nabholz, E. Bousquet, A. Ducasse, C. Arndt; Screening for Diabetic Retinopathy Using a Wide Field Imaging System. Invest. Ophthalmol. Vis. Sci. 2009;50(13):3313.
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Compare the diagnostic rate of different screening procedures (undilated retinal biomicroscopy, dilated retinal biomicroscopy and ultra widefield imaging) to identify diabetic retinopathy.
Between january 2006 and june 2008, patients with type 1 and type 2 diabetes were screened for diabetic retinopathy. A non-dilated and a dilated fundus examination was carried out by a retinal specialist. An ultra widefield non-dilated image (P200 Scanning Laser Ophthalmoscope(SLO), Optos Plc., Edinburgh, UK) was taken by an orthoptist in training. The SLO images were then analyzed by an intern masked to the fundus examination results. The results of the fundus examinations were then compared with those obtained from the SLO.
183 diabetic patients were evaluated (n=366 eyes), the sensitivity of the clinical fundus examination to detect diabetic retinopathy ranged from 90% (undilated) to 95% (dilated). Among the 18 eyes (10%) in which the diagnosis was missed clinically only one eye (0,5%) had severe non proliferative diabetic retinopathy . Less than 1% of the lesions detected by the clinical fundus examination were missed by the P200 SLO image reading.
The diagnostic rate of diabetic retinopathy using undilated SLO images was significantly higher (p< 0.001) when compared with the diagnostic rate of undilated and dilated retinal biomicroscopy. Interestingly, the undilated biomicroscopy missed twice as much lesions than the dilated biomicroscopy.
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