Efficacy of Single-Field Non-Mydriatic Digital Fundus Photography for Screening Diabetic Retinopathy

Lee, Dae Woong; Bae, Jeong Hoon; Song, Su Jeong

Abstract

PURPOSE
To evaluate the efficacy of a single field, non-mydriatic, 45degrees digital photography as a diagnostic tool for diabetic retinopathy.
METHODS
A total of 303 consecutive diabetic patients (606 eyes) who underwent digital fundus photography and indirect ophthalmoscopy were included in the present study. The optical discs and macular area of all patients were subjected to single fundus photography using a non-mydriatic 45-degree digital fundus camera. All patients also underwent fundus examinations after pupil dilation via indirect ophthalmoscopy.
RESULTS
The sensitivity and specificity for determining diabetic retinopathy were 47.6% and 97.6%, respectively. The false positive rate, false negative rate, positive predictive value, and negative predictive values were 2.3%, 2.1%, 45.5%, and 97.8%, respectively. Among the digital fundus images, 12.9% (78 eyes) were non-gradable. The patients with non-gradable digital fundus images were older (p < 0.001), had a longer duration of diabetes, (p < 0.001) and more often suffered from systemic hypertension (p = 0.003) compared to patients with gradable photographs.
CONCLUSIONS
The present study showed that single-field, non-mydriatic, 45 degree digital photography for detecting diabetic retinopathy had relatively low sensitivity and high technical failure rates. The failure rates could be improved with higher resolution non-mydriatic wide-field photography cameras and with additional peripheral images for diabetic retinopathy screening.