Screening Tool For Diabetic Retinopathy Research Articles

Validation of Smartphone Based Retinal Photography for Diabetic Retinopathy Screening.

AimTo evaluate the sensitivity and specificity of “fundus on phone’ (FOP) camera, a smartphone based retinal imaging system, as a screening tool for diabetic retinopathy (DR) detection and DR severity in comparison with 7-standard field digital retinal photography.DesignSingle-site, prospective, comparative, instrument validation study.Methods301 patients (602 eyes) with type 2 diabetes underwent standard seven-field digital fundus photography with both Carl Zeiss fundus camera and indigenous FOP at a tertiary care diabetes centre in South India. Grading of DR was performed by two independent retina specialists using modified Early Treatment of Diabetic Retinopathy Study grading system. Sight threatening DR (STDR) was defined by the presence of proliferative DR(PDR) or diabetic macular edema. The sensitivity, specificity and image quality were assessed.ResultsThe mean age of the participants was 53.5 ±9.6 years and mean duration of diabetes 12.5±7.3 years. The Zeiss camera showed that 43.9% had non-proliferative DR(NPDR) and 15.3% had PDR while the FOP camera showed that 40.2% had NPDR and 15.3% had PDR. The sensitivity and specificity for detecting any DR by FOP was 92.7% (95%CI 87.8–96.1) and 98.4% (95%CI 94.3–99.8) respectively and the kappa (ĸ) agreement was 0.90 (95%CI-0.85–0.95 p<0.001) while for STDR, the sensitivity was 87.9% (95%CI 83.2–92.9), specificity 94.9% (95%CI 89.7–98.2) and ĸ agreement was 0.80 (95%CI 0.71–0.89 p<0.001), compared to conventional photography.ConclusionRetinal photography using FOP camera is effective for screening and diagnosis of DR and STDR with high sensitivity and specificity and has substantial agreement with conventional retinal photography.

The reliability of single‐field fundus photography in screening for diabetic retinopathy: the Central Australian Ocular Health Study

To assess the accuracy of grading diabetic retinopathy (DR) using single-field digital fundus photography compared with clinical grading from a dilated slit-lamp fundus examination in Indigenous Australians living in Central Australia. Cross-sectional study comparing DR grades in participants with diabetes mellitus presenting for examination at remote community clinics from 1 July 2005 to 30 June 2008. Sensitivity and specificity of grading using digital photography compared with the clinical gold standard of slit-lamp fundus examination. Of the 1884 participants recruited for the study, 1040 had self-reported diabetes mellitus and, of those, 360 had fundus photographs available (706 eyes) that were able to be graded. On clinical grading, 163 eyes had any DR and 51 eyes had vision-threatening DR (VTDR). The sensitivity and specificity for detecting any DR were 74% (95% CI, 67%-80%) and 92% (95% CI, 90%-94%), respectively. The sensitivity and specificity for detecting VTDR were 86% (95% CI, 77%-96%) and 95% (95% CI, 93%-97%), respectively. Single-field digital fundus photography is a valid screening tool for DR in remote communities of central Australia and may be used to provide eye care services to this region with acceptable accuracy.

The potential of digital monochrome images versus colour slides in telescreening for diabetic retinopathy

We explored the potential of digital monochrome images as an alternative to colour slides in screening for diabetic retinopathy. Twenty-eight patients with diabetes were recruited for the study and 20 actually participated. Using a fundus camera (Nikon 505AF) one set of three digital images and one set of three colour slides were taken per eye. Two independent ophthalmologists graded the colour slides and the digital images for diabetic retinopathy. The ophthalmologists spent about two minutes grading each set of images, suggesting that specialists could potentially screen a large number of patients. The agreement between the two screening methods was 0.95 and 0.89, with respect to disease or no disease. The agreement (kappa) between the two ophthalmologists for grade of retinopathy was 0.47 when colour slides were employed and 0.61 when digital monochrome images were employed. The results indicate that digital red-free monochrome images represent a superior screening tool for diabetic retinopathy. Tele-screening may be beneficial when patients have to travel substantial distances to visit an ophthalmologist.

Efficacy and reliability of fundus digital camera as a screening tool for diabetic retinopathy in Kuwait

Objective: Many screening and follow-up methods are available for detecting diabetic retinopathy (DR). However, once patients develop retinopathy, it is unclear as to what method should be used for their review. This study is designed to assess the correlation between fundus digital image and clinical examination and to develop a screening program for the early detection of sight-threatening DR using a Canon CF 60 UV fundus camera. Methods: Patients who were not treated for DR earlier were enrolled in the study. All patients underwent digital fundus photography. The photographs were evaluated and compared with the clinical findings as recorded by retinal specialists. DR and macular edema were analyzed separately, and the correlation was statistically measured. The kappa statistic was used to estimate the extent of the agreement between the two procedures. Results: A total of 92 eyes of 51 patients were eligible to be entered in the study. Comparison of the digital image of the fundus and the examination by an ophthalmologist showed a good correlation. The kappa score for retinopathy was estimated to be 93% with 95.6% concordance. The kappa score for diabetic maculopathy was 88% with concordance of 92.2%. Conclusion: We conclude that digital images provide an efficient method for diagnosing and classifying sight-threatening DR, particularly proliferative diabetic retinopathy (PDR). However, agreement between the digital fundus camera and clinical examination by an ophthalmologist for diabetic maculopathy detection, though substantial statistically, was not very satisfactory. It was also felt that the digital photographs can be used as a tool for teleophthalmology and can be integrated as a screening system in Kuwait.

Is digital retinal imaging alone sufficient as a screening tool for diabetic retinopathy?

AbstractAims.To determine whether the addition of direct ophthalmoscopy to digital retinal imaging confers an advantage over imaging alone.Method.Cohort study in a DGH teaching hospital, Birmingham. Two hundred diabetic patients attending eye‐screening clinics were examined by digital retinal imaging and ophthalmoscopy.Results.In 115 (57.5%) patients the quality of the image was sufficient and no additional information was gained from also carrying out ophthalmoscopy. In a total of 76, representing 38% of patients examined, the addition of ophthalmoscopy improved detection of diabetic retinopathy.Conclusion.There is an advantage in combining digital imaging and ophthalmoscopy in eye screening, as opposed to using either method individually, to improve the detection of diabetic retinopathy. Copyright © 2002 John Wiley &amp; Sons, Ltd.

Automated detection of microaneurysms in digital red‐free photographs: a diabetic retinopathy screening tool

To develop a technique to detect microaneurysms automatically in 50 degrees digital red-free fundus photographs and evaluate its performance as a tool for screening diabetic patients for retinopathy. Candidate microaneurysms are extracted, after the image has been modified to remove variations in background intensity, by algorithms that enhance small round features. Each microaneurysm candidate is then classified according to its intensity and size by the application of a set of rules derived from a training set of 102 images. When 3,783 individual images were analysed and the results compared with the opinion of a clinical research fellow examining the same images, the program achieved a sensitivity of 81% and a specificity of 93% for the detection of images containing microaneurysms. Nine hundred and twenty-five sets of 4 images per patient were then analysed and the total number of microaneurysms detected compared with the overall patient retinopathy grade derived by the clinician examining the same images. In this context, intended to mimic a screening situation, the program achieved a sensitivity of 85% and a specificity of 76% for the detection of patients with (any) retinopathy (positive predictive value 0.71, negative predictive value 0.88). An automated technique was developed to detect retinopathy in digital red-free fundus images that can form part of a diabetic retinopathy screening programme. It is believed that it can perform a useful role in this context identifying images worthy of closer inspection or eliminating 50% or more of the screening population who have no retinopathy.

Is Digital Retinal Imaging Alone Sufficient as a Screening Tool for Diabetic Retinopathy?

Aims. To determine whether the addition of direct ophthalmoscopy to digital retinal imaging confers an advantage over imaging alone. Method. Cohort study in a DGH teaching hospital, Birmingham. Two hundred diabetic patients attending eye-screening clinics were examined by digital retinal imaging and ophthalmoscopy. Results. In 115 (57.5%) patients the quality of the image was sufficient and no additional information was gained from also carrying out ophthalmoscopy. In a total of 76, representing 38% of patients examined, the addition of ophthalmoscopy improved detection of diabetic retinopathy. Conclusion. There is an advantage in combining digital imaging and ophthalmoscopy in eye screening, as opposed to using either method individually, to improve the detection of diabetic retinopathy. Copyright © 2002 John Wiley & Sons, Ltd.

A new screening tool for diabetic retinopathy: the Canon CR5 45NM retinal camera with Frost Medical Software RIS-lite digital imaging system.

The introduction of the Canon CR5 45NM non-mydriatic retinal camera with the Frost Medical Software RIS-Lite digital imaging system provides a new screening tool for diabetic retinopathy with potential for remote diagnosis and telemedicine. This paper presents a description and early evaluation of the system.