Abstract
Abstract: :
Purpose:To assess the level of agreement between digital nonmydriatic fundus image review and dilated ophthalmologic examination in determining the level of diabetic retinopathy, macular edema, and follow–up interval in a population of diabetic patients. Methods:Prospective, comparative, observational case series. Patients with either type I or type II diabetes mellitus were photographed using a 45–degree nonmydriatic digital color fundus camera and subsequently underwent dilated ophthalmologic examination by a retinal specialist to determine the level of diabetic retinopathy, macular edema, and follow–up interval. The level of agreement was analyzed using kappa statistics. Results:234 eyes of 127 patients underwent nonmydriatic digital fundus photography and dilated examination. The level of agreement between digital fundus photo review and clinical examination was moderate for level of diabetic retinopathy (K = 0.44) and macular edema (K = 0.60). The level of agreement was fair for follow–up interval (K = 0.38). Conclusions:Review of a single 45–degree nonmydriatic digital fundus photograph by an ophthalmologist can be a useful alternative to dilated fundus examination for screening for presence of diabetic retinopathy and macular edema, but can be limited by media opacities.
Keywords: diabetic retinopathy • imaging/image analysis: clinical • clinical (human) or epidemiologic studies: systems/equipment/techniques