title: Nonmydriatic digital retinal images for determining diabetic retinopathy.
abstract: OBJECTIVE
  To evaluate the efficacy of nonmydriatic digital retinal images for determining diabetic retinopathy.
  
  
  METHODS
  Single field 45-degree digital retinal images of 225 eyes from 142 diabetic patients were obtained with a nonmydriatic camera. The images were diagnosed and graded by a general ophthalmologist. These results were compared with clinical diagnosis obtained by retinal specialists, after examination by using biomicroscope with plus lens and indirect ophthalmoscope of the patients. International clinical diabetic retinopathy disease severity scale was used for grading diabetic retinopathy in all cases.
  
  
  RESULTS
  Presence of diabetic retinopathy was detected in 70 eyes (31.1%). The sensitivity and specificity for determining diabetic retinopathy was 68.57% (95%CI 57.00-78.20) and 92.25% (95%CI 87.00-95.50), respectively. The positive predictive value and negative predictive value was 80.00% (95%CI 68.20-88.20) and 86.67% (95%CI 80.60-91.00). Overall accuracy was 84.89%.
  
  
  CONCLUSIONS
  Single field 45-degree nonmydriatic digital retinal images were limited by fair sensitivity for determining diabetic retinopathy although overall accuracy from the present study was relatively high. Upcountry, this tool might facilitate increased access of diabetic patients for eye evaluation but cannot replace standard eye examination.
authors.affiliation: Department of Ophthalmology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand.
authors.forename: Jutalai
authors.initials: J
authors.lastname: Tanterdtham
authors.forename: Apichart
authors.initials: A
authors.lastname: Singalavanija
authors.forename: Chakrapong
authors.initials: C
authors.lastname: Namatra
authors.forename: Adisak
authors.initials: A
authors.lastname: Trinavarat
authors.forename: Nuttawut
authors.initials: N
authors.lastname: Rodanant
authors.forename: Parapun
authors.initials: P
authors.lastname: Bamroongsuk
authors.forename: Somanus
authors.initials: S
authors.lastname: Thoongsuwan
authors.forename: Wanna
authors.initials: W
authors.lastname: Euasobhon
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D003930:Diabetic Retinopathy / Q000175:diagnosis*; D003941:Diagnostic Techniques, Ophthalmological; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies