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Ophthalmology. 2011 Aug;118(8):1588-93. doi: 10.1016/j.ophtha.2011.04.009.

Retinal video recording a new way to image and diagnose diabetic retinopathy.

Author information

  • 1Center for Ophthalmology and Visual Sciences, Lions Eye Institute, University of Western Australia, Nedlands, Australia. daniel_ting45@hotmail.com

Abstract

PURPOSE:

To validate the use of retinal video recording for diabetic retinopathy screening by comparing with standard retinal photography and slit-lamp examination.

DESIGN:

Evaluation of a new diagnostic technique.

PARTICIPANTS:

One hundred patients.

METHODS:

All fundus images were captured using standard retinal still photography (FF 450 plus; Carl Zeiss) and retinal video (EyeScan; Ophthalmic Imaging System, Sacramento, CA), followed by a gold standard slit-lamp biomicroscopy examination. All videos and still images were de-identified, randomized, and interpreted by 2 senior consultant ophthalmologists (M.L.T-K. and L.L.). Kappa statistics, sensitivity, and specificity for all the diabetic retinopathy signs and grades were calculated with reference to slit-lamp examination results as the gold standard.

MAIN OUTCOME MEASURES:

Sensitivity and specificity of video recording for detecting diabetic retinopathy signs and grades.

RESULTS:

The mean age (± standard deviation [SD]) of participants was 52.8 ± 15.1 years, mean duration of diabetes (± SD) was 13.7 ± 9.7 years, and the mean glycosylated hemoglobin level was 8.0 ± 1.7%. Compared with the gold standard slit-lamp examination results, the sensitivity and specificity of video recording for detecting the presence of any diabetic retinopathy was 93.8% and 99.2%, respectively (ophthalmologist 1), and 93.3% and 95.2%, respectively (ophthalmologist 2). In contrast, the sensitivity and specificity of retinal photography was 91.8% and 98.4%, respectively (ophthalmologist 1), and 92.1% and 96.8%, respectively (ophthalmologist 2), for detection of any diabetic retinopathy. Both imaging methods had 100% sensitivity and specificity in detecting sight-threatening diabetic retinopathy. For overall diabetic retinopathy grading by both ophthalmologists, the measurements of agreement (Cohen's κ coefficient) between the overall grading obtained from the retinal video versus slit-lamp examination and retinal photography versus slit-lamp examination were more than 0.90. Technical failure rate for retinal video recording and retinal photography were 7.0% and 5.5%, respectively.

CONCLUSIONS:

This study demonstrated that retinal video recording was equally as effective as retinal photography in the subjects evaluated in this study. It is a novel alternative diabetic retinopathy screening technique that not only offers primary eye care providers the opportunity to view numerous retinal fields within a short period but also is easy to learn by nonexperienced personnel with minimal training.

FINANCIAL DISCLOSURE(S):

Proprietary or commercial disclosure may be found after the references.

Copyright © 2011 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

PMID:
21684608
[PubMed - indexed for MEDLINE]
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