title: Diagnostic Accuracy of Nonmydriatic Fundus Photography for the Detection of Glaucoma in Diabetic Patients.
abstract: OBJECTIVE
  To determine the diagnostic accuracy for glaucoma of a set of criteria with nonmydriatic monoscopic fundus photography (NMFP) in diabetics.
  
  
  METHODS
  Diabetics recruited from a screening program for diabetic retinopathy and diabetic glaucoma patients recruited from our glaucoma unit were included. Any patient with evidence of diabetic retinopathy was excluded. Diabetic patients had to have no visual field defects to be included as controls. Glaucoma patients had to have a glaucomatous field defect in at least one eye to be included. One NMFP was taken per eye for all subjects. These photographs were evaluated by two masked glaucoma specialists for the presence of the following: bilateral cup to disc (C/D) ratio ≥ 0.6, notching or thinning of the neuroretinal rim, disc hemorrhages, and asymmetry in the C/D ratio between both eyes ≥ 0.2. This evaluation led to a dichotomous classification: if any of the above criteria was present, the patient was classified as glaucoma. If none were present, the patient was classified as normal.
  
  
  RESULTS
  72 control subjects and 72 glaucoma patients were included. Evaluation of NMFP had a sensitivity of 79.17% and a specificity of 80.56% for specialist 1 and a sensitivity of 72.22% and a specificity of 88.88% for specialist 2 for the detection of glaucoma. The overall accuracy was 79.83% and 80.55%, respectively.
  
  
  CONCLUSIONS
  NMFP evaluation by a glaucoma specialist may be useful for the detection of glaucoma in diabetics.
authors.affiliation: Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigaciones Sanitarias (IRYCIS), 28034 Madrid, Spain ; Universidad de Alcalá, Alcalá de Henares, Spain ; Ocular Pathology National Net (OFTARED) of the Institute of Health Carlos III, Madrid, Spain.
authors.forename: Francisco J
authors.initials: FJ
authors.lastname: Muñoz-Negrete
authors.affiliation: Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigaciones Sanitarias (IRYCIS), 28034 Madrid, Spain ; Ocular Pathology National Net (OFTARED) of the Institute of Health Carlos III, Madrid, Spain.
authors.forename: Inés
authors.initials: I
authors.lastname: Contreras
authors.affiliation: Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigaciones Sanitarias (IRYCIS), 28034 Madrid, Spain.
authors.forename: Noelia
authors.initials: N
authors.lastname: Oblanca
authors.affiliation: Ocular Pathology National Net (OFTARED) of the Institute of Health Carlos III, Madrid, Spain ; Ophthalmology Research Unit "Santiago Grisolía", Faculty of Medicine and Odontology, University of Valencia, Valencia, Spain.
authors.forename: M Dolores
authors.initials: MD
authors.lastname: Pinazo-Durán
authors.affiliation: Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigaciones Sanitarias (IRYCIS), 28034 Madrid, Spain ; Universidad de Alcalá, Alcalá de Henares, Spain ; Ocular Pathology National Net (OFTARED) of the Institute of Health Carlos III, Madrid, Spain.
authors.forename: Gema
authors.initials: G
authors.lastname: Rebolleda
mesh_terms: D000368:Aged; D016022:Case-Control Studies; D048909:Diabetes Complications / Q000175:diagnosis*; D003941:Diagnostic Techniques, Ophthalmological / Q000592:standards*; D005260:Female; D005901:Glaucoma / Q000175:diagnosis*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests