Screening for vision-threatening diabetic retinopathy in South India: Comparing portable non-mydriatic and standard fundus cameras and clinical exam

S. Sengupta, M. D. Sindal, C. G. Besirli, S. Upadhyaya, R. Venkatesh, L. M. Niziol, Alan L. Robin, M. A. Woodward, P. A. Newman-Casey

Research output: Contribution to journalArticle

Abstract

PurposeTo evaluate the sensitivity and specificity of a portable non-mydriatic fundus camera to diagnose vision-threatening diabetic retinopathy (VTDR).Patients and methodsA prospective, single-site, comparative instrument validation study was undertaken at the Aravind Eye Care System. Overall, 155 subjects with and without diabetes were recruited. Images from 275 eyes were obtained with the (1) non-mydriatic Smartscope, (2) mydriatic Smartscope, and (3) mydriatic table-top camera of the macular, nasal, and superotemporal fields. A retina specialist performed a dilated fundus examination (DFE), (reference standard). Two masked retina specialists graded the images. Sensitivity and specificity to detect VTDR with the undilated Smartscope was calculated compared to DFE.ResultsGraders 1 and 2 had a sensitivity of 93% (95% confidence interval (CI): 87-97%) and 88% (95% CI: 81-93%) and a specificity of 84% (95% CI: 77-89%) and 90% (95% CI: 84-94%), respectively, in diagnosing VTDR with the undilated Smartscope compared to DFE. Compared with the dilated Topcon images, graders 1 and 2 had sensitivity of 88% (95% CI: 81-93%) and 82% (95% CI: 73-88%) and specificity of 99% (95% CI: 96-100%) and 99% (95% CI: 95-100%).ConclusionsRemote graders had high sensitivity and specificity in diagnosing VTDR with undilated Smartscope images, suggesting utility where portability is a necessity.

Original languageEnglish (US)
Pages (from-to)375-383
Number of pages9
JournalEye (Basingstoke)
Volume32
Issue number2
DOIs
StatePublished - Feb 1 2018

Fingerprint

Vision Screening
Diabetic Retinopathy
India
Confidence Intervals
Mydriatics
Sensitivity and Specificity
Retina
Screening
Confidence Interval
South India
Validation Studies
Nose
Specificity

ASJC Scopus subject areas

  • Ophthalmology
  • Arts and Humanities(all)

Cite this

Sengupta, S., Sindal, M. D., Besirli, C. G., Upadhyaya, S., Venkatesh, R., Niziol, L. M., ... Newman-Casey, P. A. (2018). Screening for vision-threatening diabetic retinopathy in South India: Comparing portable non-mydriatic and standard fundus cameras and clinical exam. Eye (Basingstoke), 32(2), 375-383. https://doi.org/10.1038/eye.2017.199

Screening for vision-threatening diabetic retinopathy in South India : Comparing portable non-mydriatic and standard fundus cameras and clinical exam. / Sengupta, S.; Sindal, M. D.; Besirli, C. G.; Upadhyaya, S.; Venkatesh, R.; Niziol, L. M.; Robin, Alan L.; Woodward, M. A.; Newman-Casey, P. A.

In: Eye (Basingstoke), Vol. 32, No. 2, 01.02.2018, p. 375-383.

Research output: Contribution to journalArticle

Sengupta, S, Sindal, MD, Besirli, CG, Upadhyaya, S, Venkatesh, R, Niziol, LM, Robin, AL, Woodward, MA & Newman-Casey, PA 2018, 'Screening for vision-threatening diabetic retinopathy in South India: Comparing portable non-mydriatic and standard fundus cameras and clinical exam', Eye (Basingstoke), vol. 32, no. 2, pp. 375-383. https://doi.org/10.1038/eye.2017.199
Sengupta, S. ; Sindal, M. D. ; Besirli, C. G. ; Upadhyaya, S. ; Venkatesh, R. ; Niziol, L. M. ; Robin, Alan L. ; Woodward, M. A. ; Newman-Casey, P. A. / Screening for vision-threatening diabetic retinopathy in South India : Comparing portable non-mydriatic and standard fundus cameras and clinical exam. In: Eye (Basingstoke). 2018 ; Vol. 32, No. 2. pp. 375-383.
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abstract = "PurposeTo evaluate the sensitivity and specificity of a portable non-mydriatic fundus camera to diagnose vision-threatening diabetic retinopathy (VTDR).Patients and methodsA prospective, single-site, comparative instrument validation study was undertaken at the Aravind Eye Care System. Overall, 155 subjects with and without diabetes were recruited. Images from 275 eyes were obtained with the (1) non-mydriatic Smartscope, (2) mydriatic Smartscope, and (3) mydriatic table-top camera of the macular, nasal, and superotemporal fields. A retina specialist performed a dilated fundus examination (DFE), (reference standard). Two masked retina specialists graded the images. Sensitivity and specificity to detect VTDR with the undilated Smartscope was calculated compared to DFE.ResultsGraders 1 and 2 had a sensitivity of 93{\%} (95{\%} confidence interval (CI): 87-97{\%}) and 88{\%} (95{\%} CI: 81-93{\%}) and a specificity of 84{\%} (95{\%} CI: 77-89{\%}) and 90{\%} (95{\%} CI: 84-94{\%}), respectively, in diagnosing VTDR with the undilated Smartscope compared to DFE. Compared with the dilated Topcon images, graders 1 and 2 had sensitivity of 88{\%} (95{\%} CI: 81-93{\%}) and 82{\%} (95{\%} CI: 73-88{\%}) and specificity of 99{\%} (95{\%} CI: 96-100{\%}) and 99{\%} (95{\%} CI: 95-100{\%}).ConclusionsRemote graders had high sensitivity and specificity in diagnosing VTDR with undilated Smartscope images, suggesting utility where portability is a necessity.",
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AU - Sindal, M. D.

AU - Besirli, C. G.

AU - Upadhyaya, S.

AU - Venkatesh, R.

AU - Niziol, L. M.

AU - Robin, Alan L.

AU - Woodward, M. A.

AU - Newman-Casey, P. A.

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N2 - PurposeTo evaluate the sensitivity and specificity of a portable non-mydriatic fundus camera to diagnose vision-threatening diabetic retinopathy (VTDR).Patients and methodsA prospective, single-site, comparative instrument validation study was undertaken at the Aravind Eye Care System. Overall, 155 subjects with and without diabetes were recruited. Images from 275 eyes were obtained with the (1) non-mydriatic Smartscope, (2) mydriatic Smartscope, and (3) mydriatic table-top camera of the macular, nasal, and superotemporal fields. A retina specialist performed a dilated fundus examination (DFE), (reference standard). Two masked retina specialists graded the images. Sensitivity and specificity to detect VTDR with the undilated Smartscope was calculated compared to DFE.ResultsGraders 1 and 2 had a sensitivity of 93% (95% confidence interval (CI): 87-97%) and 88% (95% CI: 81-93%) and a specificity of 84% (95% CI: 77-89%) and 90% (95% CI: 84-94%), respectively, in diagnosing VTDR with the undilated Smartscope compared to DFE. Compared with the dilated Topcon images, graders 1 and 2 had sensitivity of 88% (95% CI: 81-93%) and 82% (95% CI: 73-88%) and specificity of 99% (95% CI: 96-100%) and 99% (95% CI: 95-100%).ConclusionsRemote graders had high sensitivity and specificity in diagnosing VTDR with undilated Smartscope images, suggesting utility where portability is a necessity.

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