title: An evaluation of fundus photography and fundus autofluorescence in the diagnosis of cuticular drusen.
abstract: OBJECTIVE
  To examine non-mydriatic fundus photography (FP) and fundus autofluorescence (FAF) as alternative non-invasive imaging modalities to fluorescein angiography (FA) in the detection of cuticular drusen (CD).
  
  
  METHODS
  Among 2953 adults from the Danish Rural Eye Study (DRES) with gradable FP, three study groups were selected: (1) All those with suspected CD without age-related macular degeneration (AMD) on FP, (2) all those with suspected CD with AMD on FP and (3) a randomly selected group with early AMD. Groups 1, 2 and 3 underwent FA and FAF and group 4 underwent FAF only as part of DRES CD substudy. Main outcome measures included percentage of correct positive and correct negative diagnoses, Cohen's κ and prevalence-adjusted and bias-adjusted κ (PABAK) coefficients of test and grader reliability.
  
  
  RESULTS
  CD was correctly identified on FP 88.9% of the time and correctly identified as not being present 83.3% of the time. CD was correctly identified on FAF 62.0% of the time and correctly identified as not being present 100.0% of the time. Compared with FA, FP has a PABAK of 0.75 (0.60 to 1.5) and FAF a PABAK of 0.44 (0.23 to 0.95).
  
  
  CONCLUSIONS
  FP is a promising, non-invasive substitute for FA in the diagnosis of CD. FAF was less reliable than FP to detect CD.
authors.affiliation: Department of Ophthalmology, Næstved Hospital, Næstved, Denmark The Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Tracy B
authors.initials: TB
authors.lastname: Høeg
authors.affiliation: Department of Ophthalmology, Næstved Hospital, Næstved, Denmark.
authors.forename: Birgitte
authors.initials: B
authors.lastname: Moldow
authors.affiliation: Department of Ophthalmology and Visual Sciences, University of Wisconsin-Madison, Madison, Wisconsin, USA.
authors.forename: Ronald
authors.initials: R
authors.lastname: Klein
authors.affiliation: The Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark Department of Ophthalmology, Capital Region Eye Clinic, Glostrup, Denmark.
authors.forename: Morten
authors.initials: M
authors.lastname: La Cour
authors.affiliation: Department of Ophthalmology, Capital Region Eye Clinic, Glostrup, Denmark.
authors.forename: Kristian
authors.initials: K
authors.lastname: Klemp
authors.affiliation: Department of Ophthalmology, Næstved Hospital, Næstved, Denmark.
authors.forename: Ditte
authors.initials: D
authors.lastname: Erngaard
authors.affiliation: The Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark Department of General Population Study, Nykøbing-Falster Hospital, Nykøbing Falster, Denmark.
authors.forename: Christina
authors.initials: C
authors.lastname: Ellervik
authors.affiliation: Department of Ophthalmology, Capital Region Eye Clinic, Glostrup, Denmark.
authors.forename: Helena
authors.initials: H
authors.lastname: Buch
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016570:Bruch Membrane / Q000473:pathology*; D003718:Denmark; D015785:Eye Diseases, Hereditary / Q000145:classification / Q000175:diagnosis*; D005260:Female; D005654:Fundus Oculi; D006801:Humans; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D061848:Optical Imaging; D010781:Photography; D012160:Retina / Q000473:pathology*; D015593:Retinal Drusen / Q000145:classification / Q000175:diagnosis*; D012424:Rural Population; D055815:Young Adult
keywords: Diagnostic tests/Investigation; Imaging; Retina