Retinal video recording a new way to image and diagnose diabetic retinopathy

Ophthalmology. 2011 Aug;118(8):1588-93. doi: 10.1016/j.ophtha.2011.04.009.

Abstract

Purpose: To validate the use of retinal video recording for diabetic retinopathy screening by comparing with standard retinal photography and slit-lamp examination.

Design: Evaluation of a new diagnostic technique.

Participants: One hundred patients.

Methods: All fundus images were captured using standard retinal still photography (FF 450 plus; Carl Zeiss) and retinal video (EyeScan; Ophthalmic Imaging System, Sacramento, CA), followed by a gold standard slit-lamp biomicroscopy examination. All videos and still images were de-identified, randomized, and interpreted by 2 senior consultant ophthalmologists (M.L.T-K. and L.L.). Kappa statistics, sensitivity, and specificity for all the diabetic retinopathy signs and grades were calculated with reference to slit-lamp examination results as the gold standard.

Main outcome measures: Sensitivity and specificity of video recording for detecting diabetic retinopathy signs and grades.

Results: The mean age (± standard deviation [SD]) of participants was 52.8 ± 15.1 years, mean duration of diabetes (± SD) was 13.7 ± 9.7 years, and the mean glycosylated hemoglobin level was 8.0 ± 1.7%. Compared with the gold standard slit-lamp examination results, the sensitivity and specificity of video recording for detecting the presence of any diabetic retinopathy was 93.8% and 99.2%, respectively (ophthalmologist 1), and 93.3% and 95.2%, respectively (ophthalmologist 2). In contrast, the sensitivity and specificity of retinal photography was 91.8% and 98.4%, respectively (ophthalmologist 1), and 92.1% and 96.8%, respectively (ophthalmologist 2), for detection of any diabetic retinopathy. Both imaging methods had 100% sensitivity and specificity in detecting sight-threatening diabetic retinopathy. For overall diabetic retinopathy grading by both ophthalmologists, the measurements of agreement (Cohen's κ coefficient) between the overall grading obtained from the retinal video versus slit-lamp examination and retinal photography versus slit-lamp examination were more than 0.90. Technical failure rate for retinal video recording and retinal photography were 7.0% and 5.5%, respectively.

Conclusions: This study demonstrated that retinal video recording was equally as effective as retinal photography in the subjects evaluated in this study. It is a novel alternative diabetic retinopathy screening technique that not only offers primary eye care providers the opportunity to view numerous retinal fields within a short period but also is easy to learn by nonexperienced personnel with minimal training.

Financial disclosure(s): Proprietary or commercial disclosure may be found after the references.

Publication types

  • Research Support, Non-U.S. Gov't
  • Validation Study

MeSH terms

  • Diabetic Retinopathy / classification
  • Diabetic Retinopathy / diagnosis*
  • Diagnostic Techniques, Ophthalmological*
  • Glycated Hemoglobin A / analysis
  • Humans
  • Middle Aged
  • Photography
  • Predictive Value of Tests
  • Reproducibility of Results
  • Sensitivity and Specificity
  • Video Recording*
  • Visual Acuity / physiology

Substances

  • Glycated Hemoglobin A
  • hemoglobin A1c protein, human