PURPOSE: To evaluate if simple- or multiple-field digital color nonmydriatic (NM) retinal images can replace 7 standard stereoscopic fundus photographs in the screening of diabetic retinopathy (DR). DESIGN: Prospective, masked, comparative case series. METHODS: One hundred and eight eyes of 55 diabetics were studied to determine single lesions and to grade clinical levels of DR and diabetic macular edema (DME) using both 1 and 3 NM digital color retinal images compared with the Early Treatment Diabetic Retinopathy Study (ETDRS) 7 standard 35-mm stereoscopic color fundus photographs (7F-ETDRS). All eyes underwent NM 45-degree field images of 1 central field (1F-NM), NM 45-degree field images of 3 fields (3F-NM), and, after pupil dilatation, 30-degree 7F-ETDRS photography. Images were analyzed by 2 independent, masked retinal specialists (S.V. and E.B.), lesion-by-lesion according to the ETDRS protocol and for clinical severity level of DR and DME according to the international classification of DR. RESULTS: Using 7F-ETDRS as the gold standard, agreement was substantial for grading clinical levels of DR and DME (kappa = 0.69 and kappa = 0.75) vs 3F-NM; moderate for DR level (kappa = 0.56) and substantial for DME (kappa = 0.66) vs 1F-NM; almost perfect for detecting presence or absence of DR (kappa = 0.88) vs both 1F-NM and 3F-NM; and almost perfect for presence or absence of DME (kappa = 0.97) vs 3F-NM and substantial (kappa = 0.75) vs 1F-NM. Sensitivity and specificity for detecting referable levels of DR were 82% and 92%, respectively, for 3F-NM and 71% and 96%, respectively, for 1F-NM. CONCLUSIONS: Three color 45-degree NM fundus fields may be an effective tool in a screening setting to determine critical levels of DR and DME for prompt specialist referral. One central 45-degree image is sufficient to determine absence or presence of DR and DME, but not for grading it.
PURPOSE: To evaluate if simple- or multiple-field digital color nonmydriatic (NM) retinal images can replace 7 standard stereoscopic fundus photographs in the screening of diabetic retinopathy (DR). DESIGN: Prospective, masked, comparative case series. METHODS: One hundred and eight eyes of 55 diabetics were studied to determine single lesions and to grade clinical levels of DR and diabetic macular edema (DME) using both 1 and 3 NM digital color retinal images compared with the Early Treatment Diabetic Retinopathy Study (ETDRS) 7 standard 35-mm stereoscopic color fundus photographs (7F-ETDRS). All eyes underwent NM 45-degree field images of 1 central field (1F-NM), NM 45-degree field images of 3 fields (3F-NM), and, after pupil dilatation, 30-degree 7F-ETDRS photography. Images were analyzed by 2 independent, masked retinal specialists (S.V. and E.B.), lesion-by-lesion according to the ETDRS protocol and for clinical severity level of DR and DME according to the international classification of DR. RESULTS: Using 7F-ETDRS as the gold standard, agreement was substantial for grading clinical levels of DR and DME (kappa = 0.69 and kappa = 0.75) vs 3F-NM; moderate for DR level (kappa = 0.56) and substantial for DME (kappa = 0.66) vs 1F-NM; almost perfect for detecting presence or absence of DR (kappa = 0.88) vs both 1F-NM and 3F-NM; and almost perfect for presence or absence of DME (kappa = 0.97) vs 3F-NM and substantial (kappa = 0.75) vs 1F-NM. Sensitivity and specificity for detecting referable levels of DR were 82% and 92%, respectively, for 3F-NM and 71% and 96%, respectively, for 1F-NM. CONCLUSIONS: Three color 45-degree NM fundus fields may be an effective tool in a screening setting to determine critical levels of DR and DME for prompt specialist referral. One central 45-degree image is sufficient to determine absence or presence of DR and DME, but not for grading it.
Authors: Dana Y Darwish; Samir N Patel; Yan Gao; Pooja Bhat; Felix Y Chau; Jennifer I Lim; Judy E Kim; Jogin Jose; Karyn E Jonas; R V Paul Chan; Supriya D Mehta; Ann-Marie Lobo Journal: Eye (Lond) Date: 2019-01-24 Impact factor: 3.775
Authors: Martha E Ryan; Ramachandran Rajalakshmi; Vijayaraghavan Prathiba; Ranjit Mohan Anjana; Harish Ranjani; K M Venkat Narayan; Timothy W Olsen; Viswanathan Mohan; Laura A Ward; Michael J Lynn; Andrew M Hendrick Journal: Ophthalmology Date: 2015-07-16 Impact factor: 12.079
Authors: Lauren P Daskivich; Carolina Vasquez; Carlos Martinez; Chi-Hong Tseng; Carol M Mangione Journal: JAMA Intern Med Date: 2017-05-01 Impact factor: 21.873
Authors: Sapna Gangaputra; Talat Almukhtar; Adam R Glassman; Lloyd Paul Aiello; Neil Bressler; Susan B Bressler; Ronald P Danis; Matthew D Davis Journal: Invest Ophthalmol Vis Sci Date: 2011-08-03 Impact factor: 4.799
Authors: S Sengupta; M D Sindal; C G Besirli; S Upadhyaya; R Venkatesh; L M Niziol; A L Robin; M A Woodward; P A Newman-Casey Journal: Eye (Lond) Date: 2017-09-15 Impact factor: 3.775