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.
Department of Ophthalmology, Ninewells Hospital and Medical School, Dundee, UK.
P J
PJ
Wilson
J D
JD
Ellis
C J
CJ
MacEwen
A
A
Ellingford
J
J
Talbot
G P
GP
Leese
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