[Validation of the electronic mailing of retinographs of diabetic patients in order to detect retinopathy in primary care].
OBJECTIVE
Evaluate concordance in biomicroscopy evaluation of diabetic retinopathy degree among ophthalmologists. Validation of e-mail transmission of digital fundus photographs of type 2 diabetes patients as a method of diabetic retinopathy detection.


METHODS
Descriptive study.


METHODS
Urban, primary health centre, and hospital.


METHODS
Type 2 diabetic patients selected of consecutive form when going to the primary health center (n=352).


METHODS
Parallel observer-blind evaluation of degree of retinopathy through biomicroscopy performed by ophthalmologists, against digital photographic images sent by e-mail taken by the family doctors. Concordance in the biomicroscopy among ophthalmologists was previously tested.


RESULTS
Retinopathy was revealed in 25.70% of the retinographs; 10.44% was mild, 12.05% moderate, and 3.21% severe. Weighted kappa was 0.876 for biomicroscopy concordance. Sensitivity in detecting retinopathy is 76.6% and specificity 95.2%; 92.7% and 99.5% for ophthalmologist-derivable retinopathy. Sensitivity was 66.7% for non-mydriatic retinograph without dilation, 76.9% with elective dilation, and 85% with the mydriatic.


CONCLUSIONS
Concordance in evaluation of retinopathy degree through biomicroscopy was "very good." This allows using a single ophthalmologist's exploration as a reference model. E-mail transmission of the photograph of the back of the eye in type 2 diabetic patients as a retinopathy detection method is feasible. Regardless of the type of retinograph used, the photographs should be taken on the dilated eye, as this significantly improves sensitivity.
Molina Fernández
Eduardo
E
Medicina Familiar y Comunitaria, UDMFyC Huelva, Distrito Sanitario Huelva-Costa, Huelva, España. udhuelva@tiscali.es
Valero Moll
M Sacramento
MS
Pedregal González
Miguel
M
Calvo Lozano
José
J
Sánchez Ramos
José Luis
JL
Díaz Rodríguez
Eusebio
E
Uceda Torres
Rosario
R
D000368:Aged; D003924:Diabetes Mellitus, Type 2 / Q000150:complications; D003930:Diabetic Retinopathy / Q000000981:diagnostic imaging*; D034742:Electronic Mail; D006801:Humans; D011320:Primary Health Care; D011859:Radiography