title: Assessment of diabetic retinopathy using two-field 60 degrees fundus photography. A comparison between red-free, black-and-white prints and colour transparencies.
abstract: OBJECTIVE
  To assess the severity of diabetic retinopathy and maculopathy by comparing two different photographic methods; two-field 60 degrees photography using red-free, black-and-white prints and colour transparencies.
  
  
  METHODS
  Two ophthalmologists independently graded the photographs of 74 patients using grading scales for retinopathy and maculopathy designed for 60 degrees photography. A set of nine 60 degrees red-free, black-and-white standard photographs were chosen to represent the severity of principal diabetic retinopathy and maculopathy abnormalities.
  
  
  RESULTS
  The inter-observer agreement for five pooled retinopathy severity levels was 88% (kappa 0.83, weighted kappa 0.96) and 81% (kappa 0.73, weighted kappa 0.89) using red-free, black-and-white prints and colour transparencies respectively. The corresponding figures for six pooled maculopathy levels were 96% (kappa 0.84, weighted kappa 0.97) and 93% (kappa 0.67, weighted kappa 0.86). The analyses revealed that red-free, black-and-white prints disclosed a higher severity level of retinopathy in 83% (Grader 1) and 76% (Grader 2) in those eyes for which the grading was discordant.
  
  
  CONCLUSIONS
  High-quality monochrome, red-free, wide-angle fundus photographs may be useful for the detection of early and advanced diabetic retinopathy.
authors.affiliation: Diabetic Retinopathy Photographic Screening Unit, Municipal Eye Clinic of Helsinki, Department of Ophthalmology, Herttoniemi Hospital, Finland.
authors.forename: G
authors.initials: G
authors.lastname: von Wendt
authors.forename: K
authors.initials: K
authors.lastname: Heikkilä
authors.forename: P
authors.initials: P
authors.lastname: Summanen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003930:Diabetic Retinopathy / Q000175:diagnosis*; D003937:Diagnosis, Differential; D001330:Electronic Data Processing; D005260:Female; D005654:Fundus Oculi; D006801:Humans; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D010781:Photography / Q000379:methods*; D012161:Retinal Artery / Q000473:pathology*; D012169:Retinal Vein / Q000473:pathology*; D012189:Retrospective Studies; D012720:Severity of Illness Index