The reliability of single-field fundus photography in screening for diabetic retinopathy: the Central Australian Ocular Health Study.
OBJECTIVE
To assess the accuracy of grading diabetic retinopathy (DR) using single-field digital fundus photography compared with clinical grading from a dilated slit-lamp fundus examination in Indigenous Australians living in Central Australia.


METHODS
Cross-sectional study comparing DR grades in participants with diabetes mellitus presenting for examination at remote community clinics from 1 July 2005 to 30 June 2008.


METHODS
Sensitivity and specificity of grading using digital photography compared with the clinical gold standard of slit-lamp fundus examination.


RESULTS
Of the 1884 participants recruited for the study, 1040 had self-reported diabetes mellitus and, of those, 360 had fundus photographs available (706 eyes) that were able to be graded. On clinical grading, 163 eyes had any DR and 51 eyes had vision-threatening DR (VTDR). The sensitivity and specificity for detecting any DR were 74% (95% CI, 67%-80%) and 92% (95% CI, 90%-94%), respectively. The sensitivity and specificity for detecting VTDR were 86% (95% CI, 77%-96%) and 95% (95% CI, 93%-97%), respectively.


CONCLUSIONS
Single-field digital fundus photography is a valid screening tool for DR in remote communities of central Australia and may be used to provide eye care services to this region with acceptable accuracy.
Sydney Hospital and Sydney Eye Hospital, Sydney, NSW, Australia. jungyeonku@hotmail.com
Janice J-Y
JJ
Ku
John
J
Landers
Tim
T
Henderson
Jamie E
JE
Craig
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001315:Australia; D003430:Cross-Sectional Studies; D003930:Diabetic Retinopathy / Q000175:diagnosis*; D005260:Female; D005451:Fluorescein Angiography / Q000379:methods / Q000592:standards; D005654:Fundus Oculi; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods / Q000592:standards; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D055815:Young Adult