Authors: Yossi Mizrachi Boris Knyazer Sara Guigui Shirley Rosen Tova Lifshitz Nadav Belfair Itamar Klemperer Marina Schneck Jaime Levy
Publish Date: 2013/12/01
Volume: 34, Issue: 4, Pages: 831-837
Abstract
To evaluate the effectiveness of the nonmydriatic digital camera for diabetic retinopathy DR screening Secondary purposes of the study were to characterize diabetic patients being screened for the presence of DR and to calculate the sensitivity specificity and positive predictive value of the test All 6962 consecutive patients with type 2 diabetes undergoing nonmydriatic digital retinal photography between January 1 2009 and June 30 2010 in eight community health clinics in the south of the country were included Comparison of a random sample of patients who underwent nonmydriatic retinal photography and who were also examined by an ophthalmologist with pupil dilation was also performed The average age of all patients was 642 years A total of 5960 cases 856 of all photographs were of adequate quality for the diagnosis DR of any degree was found in 1092 183 patients Normal fundus pictures were found in 494 of patients In 322 of cases nonDR pathologies were found Among cases in which DR was found 733 801 cases had mild nonproliferative retinopathy NPDR 71 77 cases had moderate NPDR 68 74 cases had proliferative retinopathy and 128 140 cases had diabetic macular edema Older patients had more chance of having poor quality pictures p 0001 between patients older and younger than 70 years When nonmydriatic fundus photography was compared with dilated fundus examination by an ophthalmologist sensitivity of 993 specificity of 883 and positive predictive value of 853 were found Nonmydriatic digital retinal photography is an efficient method for DR screening The test has high sensitivity and specificity The test as performed in community health centers in the south of the country contributed to the early diagnosis of 1000 cases of DR Many patients can be followed up in a fast and efficient way although the test cannot replace a complete eye examination after pupil dilation mainly in older people Other nonDR sightthreatening ocular pathologies can be also detected
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