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Effect of mydriasis and different field strategies on digital image screening of diabetic eye disease.
Br J Ophthalmol. 2004 Jul; 88(7):920-4.BJ

Abstract

AIMS

To assess the effects of (1) mydriasis and (2) single versus three field photography on screening for diabetic eye disease using digital photography

METHOD

Slit lamp examination findings were compared to digital fundal photographs for the detection of any retinopathy and for referable retinopathy in 398 patients (794 eyes). A Topcon TRC-NW6S digital non-mydriatic fundus camera was used. Three photographic strategies were used: undilated single field, dilated single field, and dilated multiple fields. The photographs were presented in random order to one of two retinal screeners. For the single field photographs the screeners were masked to the use of mydriatics. In 13% of fundal photographs, grading was performed by both, rather than just one grader.

RESULTS

Mydriasis reduced the proportion of ungradable photographs from 26% to 5% (p<0.001). Neither mydriasis nor three field photography improved the sensitivity or specificity for the detection of any retinopathy or of referable retinopathy when compared with undilated single field photography. The sensitivity and specificity for detecting referable retinopathy using undilated single field photography was 77% (95% CI 71 to 84) and 95 % (95% CI 93 to 97) respectively. Using dilated single field photography the figures were 81% (95% CI 76 to 87) and 92% (95% CI 90 to 94) respectively. Using dilated three field photography the figures were 83% (95% CI 78 to 88) and 93% (95% CI 91 to 96) respectively. Intergrader reliability for the detection of referable retinopathy in gradable photographs was excellent (Kappa values 0.86-1.00).

CONCLUSIONS

Mydriasis reduces the technical failure rate. Mydriasis and the three field photography as used in this study do not increase the sensitivity or specificity of detecting diabetic retinopathy.

Authors+Show Affiliations

Department of Ophthalmology, Ninewells Hospital and Medical School, Dundee, UK.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

15205238

Citation

Murgatroyd, H, et al. "Effect of Mydriasis and Different Field Strategies On Digital Image Screening of Diabetic Eye Disease." The British Journal of Ophthalmology, vol. 88, no. 7, 2004, pp. 920-4.
Murgatroyd H, Ellingford A, Cox A, et al. Effect of mydriasis and different field strategies on digital image screening of diabetic eye disease. Br J Ophthalmol. 2004;88(7):920-4.
Murgatroyd, H., Ellingford, A., Cox, A., Binnie, M., Ellis, J. D., MacEwen, C. J., & Leese, G. P. (2004). Effect of mydriasis and different field strategies on digital image screening of diabetic eye disease. The British Journal of Ophthalmology, 88(7), 920-4.
Murgatroyd H, et al. Effect of Mydriasis and Different Field Strategies On Digital Image Screening of Diabetic Eye Disease. Br J Ophthalmol. 2004;88(7):920-4. PubMed PMID: 15205238.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effect of mydriasis and different field strategies on digital image screening of diabetic eye disease. AU - Murgatroyd,H, AU - Ellingford,A, AU - Cox,A, AU - Binnie,M, AU - Ellis,J D, AU - MacEwen,C J, AU - Leese,G P, PY - 2004/6/19/pubmed PY - 2004/7/28/medline PY - 2004/6/19/entrez SP - 920 EP - 4 JF - The British journal of ophthalmology JO - Br J Ophthalmol VL - 88 IS - 7 N2 - AIMS: To assess the effects of (1) mydriasis and (2) single versus three field photography on screening for diabetic eye disease using digital photography METHOD: Slit lamp examination findings were compared to digital fundal photographs for the detection of any retinopathy and for referable retinopathy in 398 patients (794 eyes). A Topcon TRC-NW6S digital non-mydriatic fundus camera was used. Three photographic strategies were used: undilated single field, dilated single field, and dilated multiple fields. The photographs were presented in random order to one of two retinal screeners. For the single field photographs the screeners were masked to the use of mydriatics. In 13% of fundal photographs, grading was performed by both, rather than just one grader. RESULTS: Mydriasis reduced the proportion of ungradable photographs from 26% to 5% (p<0.001). Neither mydriasis nor three field photography improved the sensitivity or specificity for the detection of any retinopathy or of referable retinopathy when compared with undilated single field photography. The sensitivity and specificity for detecting referable retinopathy using undilated single field photography was 77% (95% CI 71 to 84) and 95 % (95% CI 93 to 97) respectively. Using dilated single field photography the figures were 81% (95% CI 76 to 87) and 92% (95% CI 90 to 94) respectively. Using dilated three field photography the figures were 83% (95% CI 78 to 88) and 93% (95% CI 91 to 96) respectively. Intergrader reliability for the detection of referable retinopathy in gradable photographs was excellent (Kappa values 0.86-1.00). CONCLUSIONS: Mydriasis reduces the technical failure rate. Mydriasis and the three field photography as used in this study do not increase the sensitivity or specificity of detecting diabetic retinopathy. SN - 0007-1161 UR - https://www.unboundmedicine.com/medline/citation/15205238/Effect_of_mydriasis_and_different_field_strategies_on_digital_image_screening_of_diabetic_eye_disease_ L2 - https://bjo.bmj.com/lookup/pmidlookup?view=long&amp;pmid=15205238 DB - PRIME DP - Unbound Medicine ER -