The incidental findings of age-related macular degeneration during diabetic retinopathy screening

Graefes Arch Clin Exp Ophthalmol. 2014 May;252(5):723-9. doi: 10.1007/s00417-013-2530-1. Epub 2013 Nov 27.


Background: The purpose of this study was to determine the reliability of detecting age-related macular degeneration (AMD) during screening for diabetic retinopathy (DR).

Methods: This prospective study included 2,003 subjects with diabetes mellitus who underwent photographic screening for DR. The reliability of detecting AMD lesions was tested by interobserver and intraobserver agreement, and the sensitivity and specificity of diagnosing AMD at different grades of severity were tested using the consensus grading of a group as the reference standard.

Results: DR affected 24.7% of the subjects. The age-standardized prevalence of early AMD was 17.9%, and late AMD was 0.1%. The interobserver and intraobserver agreement for grading AMD was substantial (k = 0.72 and 0.71 respectively, p < 0.001). It was equally good in those with different severities of DR. There was also no difference in sensitivity and specificity of detecting AMD in those with different levels of DR (sensitivity 62-68% and specificity 97-98%).

Conclusion: Intermediate- and high-risk AMD that warrant treatment with zinc and anti-oxidant supplements could be reliably detected during screening for diabetic retinopathy.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Cross-Sectional Studies
  • Diabetic Retinopathy / diagnosis*
  • Female
  • Humans
  • Incidental Findings
  • Macular Degeneration / classification
  • Macular Degeneration / diagnosis*
  • Male
  • Middle Aged
  • Mydriatics / administration & dosage
  • Observer Variation
  • Photography / methods
  • Prospective Studies
  • Pupil / drug effects
  • Reproducibility of Results
  • Sensitivity and Specificity
  • Tropicamide / administration & dosage
  • Vision Screening / methods


  • Mydriatics
  • Tropicamide