Evaluation of digital fundus images as a diagnostic method for surveillance of diabetic retinopathy

Dal W. Chun, Robert M. Bauer, Thomas P. Ward, John S B Dick, Kraig Bower

Research output: Contribution to journalArticle


Objective: The goal was to evaluate a digital imaging system for diagnosing and grading diabetic retinopathy (DR) and cystoid macular edema (CME). Methods: A single 45°, nonmydriatic, digital color photograph was taken of 231 eyes of 120 patients with diabetes mellitus. The images were graded for DR and CME by a remote ophthalmologist, and the results were compared with dilated ophthalmoscopy performed by a retina spe-cialist. Results: For DR, the level of agreement between digital image review and ophthalmoscopy was moderate (κ = 0.44). The sensitivity and specificity of digital image review were 0.60 and 1.00, respectively. For CME, the level of agreement was moderate (κ = 0.60). The sensitivity and specificity of digital image review were 0.60 and 0.99, respectively. Conclusion: A single 45°, nonmydriatic, digital image is not reliable as the sole modality for DR screening. However, with modifications, it may be useful where access to an experienced ophthalmologist is limited.

Original languageEnglish (US)
Pages (from-to)405-410
Number of pages6
JournalMilitary Medicine
Issue number4
Publication statusPublished - Apr 2007
Externally publishedYes


ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

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