title: Retinal video recording a new way to image and diagnose diabetic retinopathy.
abstract: OBJECTIVE
  To validate the use of retinal video recording for diabetic retinopathy screening by comparing with standard retinal photography and slit-lamp examination.
  
  
  METHODS
  Evaluation of a new diagnostic technique.
  
  
  METHODS
  One hundred patients.
  
  
  METHODS
  All fundus images were captured using standard retinal still photography (FF 450 plus; Carl Zeiss) and retinal video (EyeScan; Ophthalmic Imaging System, Sacramento, CA), followed by a gold standard slit-lamp biomicroscopy examination. All videos and still images were de-identified, randomized, and interpreted by 2 senior consultant ophthalmologists (M.L.T-K. and L.L.). Kappa statistics, sensitivity, and specificity for all the diabetic retinopathy signs and grades were calculated with reference to slit-lamp examination results as the gold standard.
  
  
  METHODS
  Sensitivity and specificity of video recording for detecting diabetic retinopathy signs and grades.
  
  
  RESULTS
  The mean age (± standard deviation [SD]) of participants was 52.8 ± 15.1 years, mean duration of diabetes (± SD) was 13.7 ± 9.7 years, and the mean glycosylated hemoglobin level was 8.0 ± 1.7%. Compared with the gold standard slit-lamp examination results, the sensitivity and specificity of video recording for detecting the presence of any diabetic retinopathy was 93.8% and 99.2%, respectively (ophthalmologist 1), and 93.3% and 95.2%, respectively (ophthalmologist 2). In contrast, the sensitivity and specificity of retinal photography was 91.8% and 98.4%, respectively (ophthalmologist 1), and 92.1% and 96.8%, respectively (ophthalmologist 2), for detection of any diabetic retinopathy. Both imaging methods had 100% sensitivity and specificity in detecting sight-threatening diabetic retinopathy. For overall diabetic retinopathy grading by both ophthalmologists, the measurements of agreement (Cohen's κ coefficient) between the overall grading obtained from the retinal video versus slit-lamp examination and retinal photography versus slit-lamp examination were more than 0.90. Technical failure rate for retinal video recording and retinal photography were 7.0% and 5.5%, respectively.
  
  
  CONCLUSIONS
  This study demonstrated that retinal video recording was equally as effective as retinal photography in the subjects evaluated in this study. It is a novel alternative diabetic retinopathy screening technique that not only offers primary eye care providers the opportunity to view numerous retinal fields within a short period but also is easy to learn by nonexperienced personnel with minimal training.
  
  
  BACKGROUND
  Proprietary or commercial disclosure may be found after the references.
authors.affiliation: Center for Ophthalmology and Visual Sciences, Lions Eye Institute, University of Western Australia, Nedlands, Australia. daniel_ting45@hotmail.com
authors.forename: Daniel S W
authors.initials: DS
authors.lastname: Ting
authors.forename: Mei Ling
authors.initials: ML
authors.lastname: Tay-Kearney
authors.forename: Ian
authors.initials: I
authors.lastname: Constable
authors.forename: Liam
authors.initials: L
authors.lastname: Lim
authors.forename: David B
authors.initials: DB
authors.lastname: Preen
authors.forename: Yogesan
authors.initials: Y
authors.lastname: Kanagasingam
mesh_terms: D003930:Diabetic Retinopathy / Q000145:classification / Q000175:diagnosis*; D003941:Diagnostic Techniques, Ophthalmological; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D008875:Middle Aged; D010781:Photography; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014741:Video Recording; D014792:Visual Acuity / Q000502:physiology
chemical_list: D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human