The incorporation of family physicians in the assessment of diabetic retinopathy by non-mydriatic fundus camera

Diabetes Res Clin Pract. 2010 May;88(2):184-8. doi: 10.1016/j.diabres.2010.02.001. Epub 2010 Mar 1.


Aims: To evaluate the inclusion of family physicians in screening for diabetic retinopathy.

Methods: We evaluated by non-mydriatic fundus camera 2779 diabetic patients. The family physicians made an initial evaluation of the fundus and pathological images were sent to a reference ophthalmologist. An audit was taken of all the patients at the end of the study. We analysed the concordance in: diabetic retinopathy, diabetic macular edema, and lesions in the macular area.

Results: Diabetic retinopathy was observed in 226 patients (8.1%) and diabetic macular edema in 40 patients (1.4%). Other retinal pathologies were diagnosed in 291 (11.0%). The sensitivity of the study was 95.2% for diabetic retinopathy, 96.0% for macular lesions and 92.9% for diabetic macular edema. The specificity was above 98% in the three studied variables. Cohen's Kappa coefficient was 0.82 for diabetic retinopathy, 0.81 for diabetic macular edema and 0.96 for macular lesions.

Conclusions: The inclusion of family physicians in the screening system seems to be effective in the diagnosis of diabetic retinopathy.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Diabetic Retinopathy / diagnosis*
  • Diagnostic Imaging / methods*
  • Female
  • Fundus Oculi
  • Humans
  • Macular Edema
  • Male
  • Middle Aged
  • Photography / methods
  • Physicians, Family*
  • Retinal Diseases
  • Sensitivity and Specificity