Screening for diabetic retinopathy: a comparative trial of photography and scanning laser ophthalmoscopy.
OBJECTIVE
To evaluate the sensitivity and specificity of wide-field scanning laser ophthalmoscopy (WSLO) in the detection of referable diabetic eye disease, and to compare its performance with digital retinal photography.


METHODS
Patients enrolled into the study underwent non-mydriatic WSLO imaging, then single- and dual-field mydriatic digital retinal photography, and examination with slit lamp biomicroscopy, the reference standard. Grading of retinopathy was performed in a masked fashion.


RESULTS
A total of 380 patients (759 eyes) were recruited to the study. Technical failure rates for dilated single-field retinal photography, dual-field retinal photography and undilated WSLO were 6.3, 5.8 and 10.8%, respectively (0.005 < p < 0.02 for photography vs. WSLO). The respective indices for screening sensitivity were 82.9, 82.9 and 83.6% (p > 0.2). Specificity was 92.1, 91.1 and 89.5%, respectively (p > 0.2).


CONCLUSIONS
Sensitivity and specificity for WSLO were similar to retinal photography. The technical failure rate was greater for the WSLO used in this study.
Wilson
P J
PJ
Department of Ophthalmology, Ninewells Hospital and Medical School, Dundee, UK.
Ellis
J D
JD
MacEwen
C J
CJ
Ellingford
A
A
Talbot
J
J
Leese
G P
GP
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003930:Diabetic Retinopathy / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D009887:Ophthalmoscopy / Q000379:methods*; D010781:Photography / Q000379:methods*; D011859:Radiography; D012160:Retina / Q000000981:diagnostic imaging / Q000473:pathology; D012680:Sensitivity and Specificity; D055815:Young Adult