Nonmydriatic Digital Retinal Images for Determining Diabetic Retinopathy†
Jutalai Tanterdtham MD*, Apichart Singalavanija MD*, Chakrapong Namatra MD*, Adisak Trinavarat MD*, Nuttawut Rodanant MD*, Parapun Bamroongsuk MD*, Somanus Thoongsuwan MD*, Wanna Euasobhon MD*
Affiliation : † This paper was presented as Poster in Academic meeting of the Royal College of Ophthalmologist of Thailand on 27-28 July 2006 * Department of Ophthalmology, Faculty of Medicine, Siriraj Hospital, Mahidol University
Objective : To evaluate the efficacy of nonmydriatic digital retinal images for determining diabetic retinopathy.
Materials and Methods : Single field 45-degree digital retinal images of 225 eyes from 142 diabetic patients
were obtained with a nonmydriatic camera. The images were diagnosed and graded by a general ophthal-
mologist. These results were compared with clinical diagnosis obtained by retinal specialists, after examina-
tion by using biomicroscope with plus lens and indirect ophthalmoscope of the patients. International clini-
cal diabetic retinopathy disease severity scale was used for grading diabetic retinopathy in all cases.
Results : Presence of diabetic retinopathy was detected in 70 eyes (31.1%). The sensitivity and specificity
for determining diabetic retinopathy was 68.57% (95%CI 57.00-78.20) and 92.25% (95%CI 87.00-95.50),
respectively. The positive predictive value and negative predictive value was 80.00% (95%CI 68.20-88.20)
and 86.67% (95%CI 80.60-91.00). Overall accuracy was 84.89%.
Conclusion : Single field 45-degree nonmydriatic digital retinal images were limited by fair sensitivity for
determining diabetic retinopathy although overall accuracy from the present study was relatively high.
Upcountry, this tool might facilitate increased access of diabetic patients for eye evaluation but cannot
replace standard eye examination.
Keywords : Diabetic retinopathy screening, Digital retinal images, Nonmydriatic retinal images
