Pilot Study on the Diagnostic Performance of a Portable Non-Mydriatic Retinal Camera for the Diabetic Retinopathy Diagnosis in Type 2 Diabetic Patients in Medellín, Antioquia
DOI:
https://doi.org/10.17533/udea.iatreia.311Keywords:
Diabetic Retinopathy, Ophthalmology, Photograph, TelemedicineAbstract
Introduction: Portable retinal cameras represent a potentially valuable tool in teleophthalmology to facilitate the diagnosis of diabetic retinopathy.
Objective: To evaluate the diagnostic sensitivity and specificity of a portable non-mydriatic retinal camera in diagnosing diabetic retinopathy compared to fundoscopic examination by an ophthalmologist.
Methodology: A cross-sectional study was conducted in a population over 18 years of age diagnosed with type 2 diabetes mellitus. Fundus images were obtained using the NIDEK Versacam® camera and compared with fundoscopic examination performed by an ophthalmologist. Sensitivity, specificity, positive and negative predictive values, and positive and negative likelihood ratios (LR) were calculated with their respective 95 % confidence intervals based on interpretations by three different evaluators according to the American Academy of Ophthalmology classification.
Results: Between October and November 2018, 91 images from 81 patients were obtained. Image quality was graded according to clarity classification by three independent evaluators. The analysis yielded a sensitivity of 30 % and specificity of 80 %. Images were classified as excellent in 10.4 % of cases (8-13/91), good in 10.5 % (8-12/91), acceptable in 20 % (17-19/91), and inadequate in 58 % (49-56/91).
Conclusions: Screening for diabetic retinopathy using a portable non-mydriatic retinal camera in type 2 diabetes mellitus patients yields a high number of inadequate photographs and demonstrates sensitivity below recommended standards.
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