EASDEC European Association for the Study of Diabetic Eye Complications
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EASDEC European Association for the Study of Diabetic Eye Complications |
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Abstracts: LiesenfeldB.Liesenfeld1, M.Lungershausen1, H.Bornemann1, S.Kluthe2, W.Piehlmeier2, C.Birkmann2, G.Mann2, M.Obermaier3, I.Ugi3, M.Porta4, T.Bek5, S.Aldington6, H.Mayer7, K.D.Hepp1, E.Kohner8; Internet-based screening for diabetic retinopathyDiabetes Centre Munich-Bogenhausen1, GSF-medis-Institute2, Dep. of Ophthalmology of the Technical University of Munich3, Dep. of Internal Medicine of the University of Turin4, Dep. of Ophthalmology of the University of Aarhus5, Retinopathy Grading Centre of the Imperial College London, Dep. of Ophthalmology of the Munich-Harlaching Hospital7, Division of Medicine of St.Thomas´ Hospital London8 In a clinical trial we investigated the quality of the remote assessment of digital images of the retina obtained in the routine setting of a busy regional centre for diabetes care to detect diabetic lesions. 129 consecutive patients with type 1 or 2 diabetes mellitus without previous laser therapy or history of glaucoma were screened using the following approach: two digital images and two conventional colour slides per eye (dilated pupils; image angle 50 degrees; centered on macula and nasal field, respectively) were captured. The digital images were transmitted to five expert grading centres via the Internet. Structured reports were returned via electronic mail from grading centres to guide further treatment. The colour slides were graded by a single expert of one of the grading centres using the same structured report. All study patients were examined by ophthalmologists (not specialised in diabetic retinopathy) of our clinic using slit-lamp biomicroscopy. For the five grading centres sensitivities were 67,73,82,83 and 92% (average 80%) for the referral threshold „any stage of diabetic retinopathy higher than mild non-proliferative excluding macular" with specificities in the range of 91,95,96,97 and 98% (average 96%). Macular oedema was excluded from the analysis due to the small number of patients (5) affected in the study but those patients could have been identified by their visual acuity of 6/12 or less. The calculations were obtained on the basis of the digital image with reference to the conventional colour slides. The ophthalmologist‘s examination resulted in a sensitivity of 75% and a specificity of 98%. Conclusion: Screening for diabetic retinopathy with digital images by experts resulted in a sensitivity and specificity comparable to ophtalmologists performing slit-lamp biomicroscopy. |
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