title: The incidental findings of age-related macular degeneration during diabetic retinopathy screening.
abstract: BACKGROUND
  The purpose of this study was to determine the reliability of detecting age-related macular degeneration (AMD) during screening for diabetic retinopathy (DR).
  
  
  METHODS
  This prospective study included 2,003 subjects with diabetes mellitus who underwent photographic screening for DR. The reliability of detecting AMD lesions was tested by interobserver and intraobserver agreement, and the sensitivity and specificity of diagnosing AMD at different grades of severity were tested using the consensus grading of a group as the reference standard.
  
  
  RESULTS
  DR affected 24.7% of the subjects. The age-standardized prevalence of early AMD was 17.9%, and late AMD was 0.1%. The interobserver and intraobserver agreement for grading AMD was substantial (k = 0.72 and 0.71 respectively, p < 0.001). It was equally good in those with different severities of DR. There was also no difference in sensitivity and specificity of detecting AMD in those with different levels of DR (sensitivity 62-68% and specificity 97-98%).
  
  
  CONCLUSIONS
  Intermediate- and high-risk AMD that warrant treatment with zinc and anti-oxidant supplements could be reliably detected during screening for diabetic retinopathy.
authors.affiliation: Department of Ophthalmology, The University of Hong Kong, Room 301, Block B, Cyberport 4, 100 Cyberport Road, Cyberport, Hong Kong, gangwani@hku.hk.
authors.forename: Rita
authors.initials: R
authors.lastname: Gangwani
authors.forename: Wico W
authors.initials: WW
authors.lastname: Lai
authors.forename: Rita
authors.initials: R
authors.lastname: Sum
authors.forename: Sarah M
authors.initials: SM
authors.lastname: McGhee
authors.forename: Catherine W S
authors.initials: CW
authors.lastname: Chan
authors.forename: Anthony J
authors.initials: AJ
authors.lastname: Hedley
authors.forename: David
authors.initials: D
authors.lastname: Wong
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D003930:Diabetic Retinopathy / Q000175:diagnosis*; D005260:Female; D006801:Humans; D033162:Incidental Findings; D008268:Macular Degeneration / Q000145:classification / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D009184:Mydriatics / Q000008:administration & dosage; D015588:Observer Variation; D010781:Photography / Q000379:methods; D011446:Prospective Studies; D011680:Pupil / Q000187:drug effects; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014331:Tropicamide / Q000008:administration & dosage; D015351:Vision Screening / Q000379:methods
chemical_list: D009184:Mydriatics; D014331:Tropicamide