title: Non-Mydriatic Fundus Camera Screening for Referral-Warranted Diabetic Retinopathy in a Northern California Safety-Net Setting.
abstract: To compare nonmydriatic fundus photography (nFP) screening for diabetic retinopathy (DR) with clinical dilated fundus examination (DFE) in a safety-net setting.
  
  
  
  This was a retrospective, institutional cohort study of 6,911 patients undergoing nFP screening for DR between 2008 and 2012. A subset of 1,521 patients underwent DFE, and clinical DR grade was compared with nFP DR grade.
  
  
  
  nFP screening demonstrated 17% prevalence of any DR, with moderate nonproliferative diabetic retinopathy (NPDR) or worse present in 5% of patients. Thirteen percent of photos were unreadable. When compared with DFE, sensitivity and specificity of nFP to detect moderate NPDR or worse were 91% and 97%, respectively. Area under the receiver operating characteristic curve was 0.97.
  
  
  
  The authors' study found 17% of patients screened with nFP had referral-warranted DR. These results demonstrate a use-case of telemedicine to screen large numbers of patients in a safety-net setting, but they also highlight the need for adequate specialty resources to care for referred patients. [Ophthalmic Surg Lasers Imaging Retina. 2016;47:636-642.].
authors.forename: Brian C
authors.initials: BC
authors.lastname: Toy
authors.forename: Tyler
authors.initials: T
authors.lastname: Aguinaldo
authors.forename: Joseph
authors.initials: J
authors.lastname: Eliason
authors.forename: James
authors.initials: J
authors.lastname: Egbert
mesh_terms: D002140:California / Q000453:epidemiology; D003930:Diabetic Retinopathy / Q000175:diagnosis* / Q000453:epidemiology; D005260:Female; D005451:Fluorescein Angiography; D005500:Follow-Up Studies; D005654:Fundus Oculi; D006801:Humans; D015994:Incidence; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D010781:Photography / Q000295:instrumentation*; D012017:Referral and Consultation; D012189:Retrospective Studies