Comparison of the effectiveness of detecting diabetic eye disease: Diabetic retinal photography versus ophthalmic consultation

DSY Chia, EY Yap
Correspondence: Dr Dawn Chia, dawnchia@singnet.com.sg

ABSTRACT
Introduction This study determines the accuracy of reading a Polaroid retinal photograph in the diabetic retinal photography programme as compared to a clinical fundal examination in the diagnosis of diabetic retinopathy.
Methods A prospective study recording the additional findings obtained from clinical examination of the eye using indirect ophthalmoscopy and slit lamp biomicroscopy in a restructured tertiary hospital serving an urban community was performed.
Results Seventy-eight eyes in 39 diabetic patients were reviewed by an ophthalmologist for diabetic changes seen on fundus photography. The sensitivity of diabetic retinal photography in diagnosing diabetic eye conditions was 91.6 percent, with a specificity of 99.8 percent and a positive predictive value of 95.6 percent. The degree of agreement kappa was 0.94.
Conclusion The use of diabetic retinal photographs to screen for diabetic eye disease achieved a high sensitivity by capturing diabetic retinal lesions. It was comparable to an examination performed by the ophthalmologist. With appropriate training, the person reading the diabetic retinal photographs can accurately diagnose diabetic eye conditions.

Keywords: diabetes mellitus, diabetic retinal photography, eye diseases, ophthalmologic diagnostic technique, vision tests
Singapore Med J 2004; 45(6): 276-279