High-resolution stereoscopic digital fundus photography versus contact lens biomicroscopy for the detection of clinically significant macular edema.
OBJECTIVE
The purpose of this study was to compare high-resolution stereoscopic digital photography to contact lens biomicroscopy (CLBM) for the diagnosis of clinically significant macular edema.


METHODS
Comparative, prospective, observational case series.


METHODS
One hundred twenty diabetic patients.


METHODS
Patients underwent clinical retinal examination with CLBM by a retinal specialist. On the same day as clinical grading, patients received high-resolution stereoscopic digital imaging of the macula. The stereoscopic digital images were viewed using liquid crystal shutter goggles at least 2 months after clinical examination by a single masked grader for the presence or absence of diabetic retinopathy.


METHODS
Presence or absence of the Early Treatment of Diabetic Retinopathy Study criteria for clinically significant macular edema (CSME) overall, CSME 1, CSME 2, CSME 3, macular edema, microaneurysms, intraretinal hemorrhage, and hard exudate.


RESULTS
Two hundred seven eyes of 105 patients had complete data sets from both diagnostic modalities. Exact agreement was high for all identified pathologic conditions: CSME overall, 83.6%; CSME 1, 83.6%; CSME 2, 96.1%; CSME 3, 88.5%; macular edema, 75.0%; microaneurysms, 77.9%; intraretinal hemorrhage, 83.7%; and hard exudate, 73.1%. Sensitivity ranged from 50.0% (CSME 2) to 90.6% (CSME overall). Specificity ranged from 90.0% (macular edema) to 99.0% (CSME 2).


CONCLUSIONS
High-resolution stereoscopic digital photography is both sensitive and specific when identifying CSME and correlates well with the accepted standard of CLBM for the diagnosis of CSME.
Rudnisky
Christopher J
CJ
Department of Ophthalmology, University of Alberta, Edmonton, Alberta, Canada.
Hinz
Brad J
BJ
Tennant
Matthew T S
MT
de Leon
Alexander R
AR
Greve
Mark D J
MD
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003261:Contact Lenses; D003930:Diabetic Retinopathy / Q000145:classification / Q000175:diagnosis; D003941:Diagnostic Techniques, Ophthalmological; D005260:Female; D005654:Fundus Oculi; D006801:Humans; D008269:Macular Edema / Q000145:classification / Q000175:diagnosis*; D008297:Male; D008853:Microscopy / Q000379:methods; D008875:Middle Aged; D010781:Photography / Q000379:methods; D011446:Prospective Studies; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity