ARVO 2013 EasyScan miotic staging of diabetic retinopathy compared with ophthalmoscopic fundus examination

Purpose

To determine the capacity of green / near IR nonmydriatic digital fundus camera (EasyScan, i-Optics, Netherlands) to identify the early signs of diabetic retinopathy (DR).

Material and Method

Ninety-four eyes of 47 patients (27 males and 20 females) who attended the Diabetic Center of S’Orsola Hospital between October and November 2012 were included in the present study. Field 1 and 2 ETDRS images were capture by nonmydriatic green / near IR camera. After image taking, dilated fundus examination was performed by an experienced ophthalmologist, for any evidence of diabetic retinopathy. The images were independently evaluated by two different retinal specialists and compared with the findings from ophthalmoscopic examination, which were used as a gold standard.

Results

The mean age of patients was 61±16 years, the mean duration of diabetes was 12±11 years and the mean time to acquire images was 9±4 minutes. The prevalence of DR was 44.7% of the population or 40.4% of the 94 eyes. Six fundus images (6,4%) were considered low quality for the interpretation and were excluded from the analysis. From the remaining 86 eyes, comparing the interpretation by images and the ophthalmoscopic findings, the Kappa statistic between the two screening tests was 0.401 (95% CI 0.262 – 0.540) The agreement between retinal specialists was 61.63%. The overall sensitivity and the specificity of images for screening DR were 91.2% and 50% respectively.

Conclusions

The images obtained by the green / near IR fundus camera have the advantage of a high sensitivity and a quick acquisition time. The ophthalmoscopic examination is still recommended in any cases with abnormal findings, or those with poor quality images when DR could not be definitely excluded.

By Simonetta Guidelli Guidi, Chiara Veronese, Mariachiara Morara, Carlo Torrazza, Antonio P. Ciardella. Ophthalmology – Policlinico S. Orsola-Malpighi, Bologna, Italy.