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Accuracy of single-field nonmydriatic digital fundus image in screening for diabetic retinopathy.
J Med Assoc Thai. 2008 Sep; 91(9):1397-403.JM

Abstract

OBJECTIVE

To determine the accuracy, the sensitivity and the specificity of a single-field nonmydriatic digital fundus image interpreted by an endocrinologist for diabetic retinopathy (DR) screening.

MATERIAL AND METHOD

Two hundred and forty-eight diabetic patients who attended the Diabetic Center BMA Medical College and Vajira Hospital between May 2007 and March 2008 were included in the present study. The fundus images of all patients, which would include optic nerve and macular area, were captured by a digital camera without any mydriatic agent. After image taking, the patients were subsequently examined for any evidence of diabetic retinopathy by an experienced ophthalmologist. The fundus images were later interpreted by a trained endocrinologist and would be compared with the findings from the ophthalmologist, which were used as a gold standard

RESULTS

The prevalence of DR was 24.2% of the population or 22.8% of the 495 eyes studied. Ninety-three fundus images were considered low quality for interpretation and were excluded from the analysis. From the remaining 402 eyes (155 patients), the Kappa value of the endocrinologist's interpretation and the ophthalmologist's findings was 0.48. The accuracy for screening DR by the image capture was 80.6% (95% confidence interval [CI], 76.4-84.3) while the sensitivity and specificity were 65.6% (95% CI, 60.9-70.2) and 84.9% (95% CI, 81.4-88.4), respectively. Positive predictive value and negative predictive value were 55.7% (95% CI, 50.8-60.5) and 89.5% (95% CI, 86.5-92.5), respectively

CONCLUSION

Single-field nonmydriatic digital fundus image is a convenient screening tool for a diagnosis of diabetic retinopathy. The test could be achieved by a trained endocrinologist who could practically serve the patients in one visit at diabetic clinics. A referral to an ophthalmologist is still recommended in any cases with abnormal findings, or those with questionable findings, and those with poor quality photographs when diabetic retinopathy could not be definitely excluded.

Authors+Show Affiliations

Department of Ophthalmology, BMA Medical College and Vajira Hospital, Bangkok 10300, Thailand. apichat_suan@yahoo.comNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

18843870

Citation

Suansilpong, Apichat, and Petch Rawdaree. "Accuracy of Single-field Nonmydriatic Digital Fundus Image in Screening for Diabetic Retinopathy." Journal of the Medical Association of Thailand = Chotmaihet Thangphaet, vol. 91, no. 9, 2008, pp. 1397-403.
Suansilpong A, Rawdaree P. Accuracy of single-field nonmydriatic digital fundus image in screening for diabetic retinopathy. J Med Assoc Thai. 2008;91(9):1397-403.
Suansilpong, A., & Rawdaree, P. (2008). Accuracy of single-field nonmydriatic digital fundus image in screening for diabetic retinopathy. Journal of the Medical Association of Thailand = Chotmaihet Thangphaet, 91(9), 1397-403.
Suansilpong A, Rawdaree P. Accuracy of Single-field Nonmydriatic Digital Fundus Image in Screening for Diabetic Retinopathy. J Med Assoc Thai. 2008;91(9):1397-403. PubMed PMID: 18843870.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Accuracy of single-field nonmydriatic digital fundus image in screening for diabetic retinopathy. AU - Suansilpong,Apichat, AU - Rawdaree,Petch, PY - 2008/10/11/pubmed PY - 2008/12/17/medline PY - 2008/10/11/entrez SP - 1397 EP - 403 JF - Journal of the Medical Association of Thailand = Chotmaihet thangphaet JO - J Med Assoc Thai VL - 91 IS - 9 N2 - OBJECTIVE: To determine the accuracy, the sensitivity and the specificity of a single-field nonmydriatic digital fundus image interpreted by an endocrinologist for diabetic retinopathy (DR) screening. MATERIAL AND METHOD: Two hundred and forty-eight diabetic patients who attended the Diabetic Center BMA Medical College and Vajira Hospital between May 2007 and March 2008 were included in the present study. The fundus images of all patients, which would include optic nerve and macular area, were captured by a digital camera without any mydriatic agent. After image taking, the patients were subsequently examined for any evidence of diabetic retinopathy by an experienced ophthalmologist. The fundus images were later interpreted by a trained endocrinologist and would be compared with the findings from the ophthalmologist, which were used as a gold standard RESULTS: The prevalence of DR was 24.2% of the population or 22.8% of the 495 eyes studied. Ninety-three fundus images were considered low quality for interpretation and were excluded from the analysis. From the remaining 402 eyes (155 patients), the Kappa value of the endocrinologist's interpretation and the ophthalmologist's findings was 0.48. The accuracy for screening DR by the image capture was 80.6% (95% confidence interval [CI], 76.4-84.3) while the sensitivity and specificity were 65.6% (95% CI, 60.9-70.2) and 84.9% (95% CI, 81.4-88.4), respectively. Positive predictive value and negative predictive value were 55.7% (95% CI, 50.8-60.5) and 89.5% (95% CI, 86.5-92.5), respectively CONCLUSION: Single-field nonmydriatic digital fundus image is a convenient screening tool for a diagnosis of diabetic retinopathy. The test could be achieved by a trained endocrinologist who could practically serve the patients in one visit at diabetic clinics. A referral to an ophthalmologist is still recommended in any cases with abnormal findings, or those with questionable findings, and those with poor quality photographs when diabetic retinopathy could not be definitely excluded. SN - 0125-2208 UR - https://www.unboundmedicine.com/medline/citation/18843870/Accuracy_of_single_field_nonmydriatic_digital_fundus_image_in_screening_for_diabetic_retinopathy_ L2 - https://medlineplus.gov/diabeticeyeproblems.html DB - PRIME DP - Unbound Medicine ER -