Beyond retinal screening: Digital imaging in the assessment and follow- up of patients with diabetic retinopathy

Authors: Kerr, D., Cavan, D.A., Jennings, B., Dunnington, C., Gold, D. and Crick, M.

Journal: Diabetic Medicine

Volume: 15

Issue: 10

Pages: 878-882

ISSN: 0742-3071

DOI: 10.1002/(SICI)1096-9136(199810)15:10<878::AID-DIA686>3.0.CO;2-3

Abstract:

Many screening methods are available for detecting diabetic retinopathy. However, once patients develop retinopathy, it is unclear as to what method should be used for their review. We describe a novel and integrated system for the screening and treatment of diabetic retinopathy using high street optometrists for primary screening and digital imaging as a secondary screening tool, with referral to a joint retinal clinic only where ophthalmological intervention may be required. Of 3586 patients screened by optometrists, 328 were classified as having moderate/severe pre-proliferative retinopathy or diabetic maculopathy. Patients with proliferative retinopathy (1% of the total) were recalled directly to the joint retinal clinic. A consecutive sample (281) of these patients, together with a further 100 classified by the optometrists as having no or background retinopathy were compared using digital images and standard 35 mm colour transparencies. These, together with the original optometrist reports, were reviewed independently and individually by an opthalmologist. A further sample of 124 patients who had undergone both digital imaging and ophthalmologist slit- lamp examination were also compared. Comparison of 35 mm colour transparencies with optometrist reports showed the latter had a sensitivity for detecting sight-threatening retinopathy (STR) of 62 %, a specificity of 84 %, and a kappa score of 0.62. The results for digital images were 90 %, 97 %, and 0.90, respectively, although the extent of retinopathy was under- reported in 10 patients. With opthalmologist slit-lamp examination as the gold standard, the sensitivity of digital imaging was 90 % with a substantial level of agreement between them (kappa 0.61). We conclude that digital images provide an efficient method for the follow-up of patients with established or previously treated retinopathy.

Source: Scopus

Beyond retinal screening: digital imaging in the assessment and follow-up of patients with diabetic retinopathy.

Authors: Kerr, D., Cavan, D.A., Jennings, B., Dunnington, C., Gold, D. and Crick, M.

Journal: Diabet Med

Volume: 15

Issue: 10

Pages: 878-882

ISSN: 0742-3071

DOI: 10.1002/(SICI)1096-9136(199810)15:10<878::AID-DIA686>3.0.CO;2-3

Abstract:

Many screening methods are available for detecting diabetic retinopathy. However, once patients develop retinopathy, it is unclear as to what method should be used for their review. We describe a novel and integrated system for the screening and treatment of diabetic retinopathy using high street optometrists for primary screening and digital imaging as a secondary screening tool, with referral to a joint retinal clinic only where ophthalmological intervention may be required. Of 3586 patients screened by optometrists, 328 were classified as having moderate/severe pre-proliferative retinopathy or diabetic maculopathy. Patients with proliferative retinopathy (1% of the total) were recalled directly to the joint retinal clinic. A consecutive sample (281) of these patients, together with a further 100 classified by the optometrists as having no or background retinopathy were compared using digital images and standard 35 mm colour transparencies. These, together with the original optometrist reports, were reviewed independently and individually by an ophthalmologist. A further sample of 124 patients who had undergone both digital imaging and ophthalmologist slit-lamp examination were also compared. Comparison of 35 mm colour transparencies with optometrist reports showed the latter had a sensitivity for detecting sight-threatening retinopathy (STR) of 62%, a specificity of 84%, and a kappa score of 0.62. The results for digital images were 90%, 97%, and 0.90, respectively, although the extent of retinopathy was under-reported in 10 patients. With ophthalmologist slit-lamp examination as the gold standard, the sensitivity of digital imaging was 90% with a substantial level of agreement between them (kappa 0.61). We conclude that digital images provide an efficient method for the follow-up of patients with established or previously treated retinopathy.

Source: PubMed

Beyond retinal screening: Digital imaging in the assessment and follow-up of patients with diabetic retinopathy

Authors: Kerr, D., Cavan, D.A., Jennings, B., Dunnington, C., Gold, D. and Crick, M.

Journal: DIABETIC MEDICINE

Volume: 15

Issue: 10

Pages: 878-882

ISSN: 0742-3071

DOI: 10.1002/(SICI)1096-9136(199810)15:10<878::AID-DIA686>3.0.CO;2-3

Source: Web of Science (Lite)

Beyond retinal screening: digital imaging in the assessment and follow-up of patients with diabetic retinopathy

Authors: Kerr, D., Cavan, D.A., Jennings, B., Dunnington, C., Gold, D. and Crick, M.D.

Journal: Diabetic Medicine

Volume: 15

Pages: 878-882

ISSN: 0742-3071

DOI: 10.1002/(SICI)1096-9136(199810)15:10<878::AID-DIA686>3.0.CO;2-3

Abstract:

Many screening methods are available for detecting diabetic retinopathy. However, once patients develop retinopathy, it is unclear as to what method should be used for their review. We describe a novel and integrated system for the screening and treatment of diabetic retinopathy using high street optometrists for primary screening and digital imaging as a secondary screening tool, with referral to a joint retinal clinic only where ophthalmological intervention may be required. Of 3586 patients screened by optometrists, 328 were classified as having moderate/severe pre-proliferative retinopathy or diabetic maculopathy. Patients with proliferative retinopathy (1 % of the total) were recalled directly to the joint retinal clinic. A consecutive sample (281) of these patients, together with a further 100 classified by the optometrists as having no or background retinopathy were compared using digital images and standard 35 mm colour transparencies. These, together with the original optometrist reports, were reviewed independently and individually by an opthalmologist. A further sample of 124 patients who had undergone both digital imaging and ophthalmologist slit-lamp examination were also compared. Comparison of 35 mm colour transparencies with optometrist reports showed the latter had a sensitivity for detecting sight-threatening retinopathy (STR) of 62 %, a specificity of 84 %, and a kappa score of 0.62. The results for digital images were 90 %, 97 %, and 0.90, respectively, although the extent of retinopathy was under-reported in 10 patients. With opthalmologist slit-lamp examination as the gold standard, the sensitivity of digital imaging was 90 % with a substantial level of agreement between them (kappa 0.61). We conclude that digital images provide an efficient method for the follow-up of patients with established or previously treated retinopathy.

http://www3.interscience.wiley.com/cgi-bin/abstract/109565700/ABSTRACT

Source: Manual

Preferred by: David Kerr

Beyond retinal screening: digital imaging in the assessment and follow-up of patients with diabetic retinopathy.

Authors: Kerr, D., Cavan, D.A., Jennings, B., Dunnington, C., Gold, D. and Crick, M.

Journal: Diabetic medicine : a journal of the British Diabetic Association

Volume: 15

Issue: 10

Pages: 878-882

eISSN: 1464-5491

ISSN: 0742-3071

DOI: 10.1002/(sici)1096-9136(199810)15:10<878::aid-dia686>3.0.co;2-3

Abstract:

Many screening methods are available for detecting diabetic retinopathy. However, once patients develop retinopathy, it is unclear as to what method should be used for their review. We describe a novel and integrated system for the screening and treatment of diabetic retinopathy using high street optometrists for primary screening and digital imaging as a secondary screening tool, with referral to a joint retinal clinic only where ophthalmological intervention may be required. Of 3586 patients screened by optometrists, 328 were classified as having moderate/severe pre-proliferative retinopathy or diabetic maculopathy. Patients with proliferative retinopathy (1% of the total) were recalled directly to the joint retinal clinic. A consecutive sample (281) of these patients, together with a further 100 classified by the optometrists as having no or background retinopathy were compared using digital images and standard 35 mm colour transparencies. These, together with the original optometrist reports, were reviewed independently and individually by an ophthalmologist. A further sample of 124 patients who had undergone both digital imaging and ophthalmologist slit-lamp examination were also compared. Comparison of 35 mm colour transparencies with optometrist reports showed the latter had a sensitivity for detecting sight-threatening retinopathy (STR) of 62%, a specificity of 84%, and a kappa score of 0.62. The results for digital images were 90%, 97%, and 0.90, respectively, although the extent of retinopathy was under-reported in 10 patients. With ophthalmologist slit-lamp examination as the gold standard, the sensitivity of digital imaging was 90% with a substantial level of agreement between them (kappa 0.61). We conclude that digital images provide an efficient method for the follow-up of patients with established or previously treated retinopathy.

Source: Europe PubMed Central