May 2003
Volume 44, Issue 13
Free
ARVO Annual Meeting Abstract  |   May 2003
Multifield Non-Mydriatic Digital Fundus Photography Versus High-Resolution Stereoscopic Digital Imaging for the Tele-Ophthalmologic Diagnosis of Diabetic Retinopathy
Author Affiliations & Notes
  • C.J. Rudnisky
    Ophthalmology, Univ of Alberta/RAH, Edmonton, AB, Canada
  • M.D. Greve
    Ophthalmology, Univ of Alberta/RAH, Edmonton, AB, Canada
  • P. Sanghera
    Ophthalmology, University of Toronto, Toronto, ON, Canada
  • M.T. Tennant
    Retina Service, Wills Eye Hospital, Philadelphia, PA, United States
  • N. Heyns
    Retina Service, Wills Eye Hospital, Philadelphia, PA, United States
  • B.J. Hinz
    Retina Service, Wills Eye Hospital, Philadelphia, PA, United States
  • A.R. DeLeon
    Mathematics, University of Calgary, Calgary, AB, Canada
Investigative Ophthalmology & Visual Science May 2003, Vol.44, 4283. doi:
  • Views
  • Share
  • Tools
    • Alerts
      ×
      This feature is available to authenticated users only.
      Sign In or Create an Account ×
    • Get Citation

      C.J. Rudnisky, M.D. Greve, P. Sanghera, M.T. Tennant, N. Heyns, B.J. Hinz, A.R. DeLeon; Multifield Non-Mydriatic Digital Fundus Photography Versus High-Resolution Stereoscopic Digital Imaging for the Tele-Ophthalmologic Diagnosis of Diabetic Retinopathy . Invest. Ophthalmol. Vis. Sci. 2003;44(13):4283.

      Download citation file:


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

      ×
  • Supplements
Abstract

Abstract: : Purpose: To compare nonmydriatic digital retinal photography, the method used by most tele-ophthalmology groups, with high-resolution stereoscopic digital imaging for the diagnosis and management of diabetic retinopathy. Methods: Following informed consent and prior to pupillary dilation, 36 patients (72 eyes) from a remote northern Alberta community had three digital nonmydriatic fundus photographs captured per eye. Following mydriasis, seven 30 degree high resolution digital images were obtained, with Airlee House Fields 1 and 2 captured in stereo. Both formats were archived, transported and then randomly reviewed in Edmonton for image quality, microaneurysms, intraretinal hemorrhage, hard exudates, cotton-wool spots, intraretinal microvascular abnormalities, venous beading, clinically significant macular edema (in the high-resolution stereo images), presumed CSME (in the non-stereo nonmydriatic images), neovascularization, and vitreous and preretinal hemorrhage. The level of diabetic retinopathy and recommended clinical follow-up was also recorded. To limit reader bias, the reading of the nonmydriatic images and high-resolution images was conducted a minimum of 2 weeks apart. Results: The nonmydriatic camera had good or excellent correlation (kappa statistic 0.484 - 0.811) with high-resolution stereoscopic digital imaging for all pathologies except CSME and microaneurysms. Similarly, the nonmydriatic camera had good or better correlation for all diagnoses in this cohort (kappa statistic 0.424 - .0525) except very mild NPDR. The sensitivity of the nonmydriatic camera ranged from 25% (CSME) to 75% (intraretinal hemorrhage). Specificity was high for all measured pathologies ranging from 91.5% to 100%. However, the nonmydriatic camera produced 5 times as many ungradeable images and required clinical re-examination for nearly three times as many patients. Conclusions: Because of both better image quality and stereopsis, high-resolution stereoscopic digital imaging detects more treatable diabetic retinopathy and results in fewer rural diabetic patients requiring needless referral for clinical re-examination. High-resolution stereoscopic digital imaging may result in a cost benefit for health care providers.

Keywords: diabetic retinopathy • imaging/image analysis: clinical • diabetes 
×
×

This PDF is available to Subscribers Only

Sign in or purchase a subscription to access this content. ×

You must be signed into an individual account to use this feature.

×