The effectiveness of screening for diabetic retinopathy by digital imaging photography and technician ophthalmoscopy

Scanlon, Peter H ORCID: 0000-0001-8513-710X, Malhotra, R, Thomas, G, Foy, C, Kirkpatrick, J N, Lewis-Barned, N, Harney, B and Aldington, S J (2003) The effectiveness of screening for diabetic retinopathy by digital imaging photography and technician ophthalmoscopy. Diabetic Medicine, 20 (6). pp. 467-474.

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Abstract

AIMS: To evaluate the introduction of a community-based non-mydriatic and mydriatic digital photographic screening programme by measuring the sensitivity and specificity compared with a reference standard and assessing the added value of technician direct ophthalmoscopy. METHODS: Study patients had one-field, non-mydriatic, 45 degrees digital imaging photography prior to mydriatic two-field digital imaging photography followed by technician ophthalmoscopy. Of these patients, 1549 were then examined by an experienced ophthalmologist using slit lamp biomicroscopy as a reference standard. The setting was general practices in Gloucestershire. Patients were selected by randomizing groups of patients (from within individual general practices) and 3611 patients were included in the study. Patients for reference standard examination were recruited from groups of patients on days when the ophthalmologist was able to attend. The main outcome measure was detection of referable diabetic retinopathy (DR) as defined by the Gloucestershire adaptation of the European Working Party guidelines. RESULTS: For mydriatic digital photography, the sensitivity was 87.8%, specificity was 86.1% and technical failure rate was 3.7%. Technician ophthalmoscopy did not alter these figures. For non-mydriatic photography, the sensitivity was 86.0%, specificity was 76.7% and technical failure rate was 19.7%. CONCLUSIONS: Two-field mydriatic digital photography is an effective method of screening for referable diabetic retinopathy. Non-mydriatic digital photography has an unacceptable technical failure rate and low specificity.

Item Type:	Article
Article Type:	Article
Subjects:	R Medicine > RA Public aspects of medicine > RA645.A-Z Individual diseases or groups of diseases, A-Z > RA645.D54 Diabetes R Medicine > RE Ophthalmology
Divisions:	Schools and Research Institutes > School of Education and Science
Research Priority Areas:	Health, Life Sciences, Sport and Wellbeing
Depositing User:	Anne Pengelly
Date Deposited:	01 Jun 2016 13:06
Last Modified:	31 Aug 2023 09:11
URI:	https://eprints.glos.ac.uk/id/eprint/3577

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