Department of Ophthalmology, School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda.
Department of Immunology and Molecular Biology, School of Biomedical Sciences, College of Health Sciences, Makerere University, Kampala, Uganda.
PLoS One. 2022 Sep 6;17(9):e0273633. doi: 10.1371/journal.pone.0273633. eCollection 2022.
Diabetic retinopathy (DR) is one of the major complications of diabetes mellitus and is a significant cause of blindness worldwide. In Uganda, the prevalence of diabetes is approximately 2.7% of the urban population and 1% in rural areas. Many diabetics cannot access an eye exam due to the lack of less costly and user-friendly equipment that primary eye workers can use. Smartphone-based fundus photography allows for a cheap and mobile fundus examination. The study aimed to determine the sensitivity and specificity of the Portable Eye Examination Kit (PEEK) retina compared to a standard ophthalmic fundus camera (Zeiss Visucam 200) for the diagnosis of DR.
From January-March 2020, 286 people with diabetes (type 1 & 2) patients were seen at Kiruddu National referral hospital diabetes clinic. All participants had funduscopy with PEEK retina and the standard ophthalmic fundus camera following ophthalmic examination and pupillary dilation. The PEEK retina's sensitivity, specificity and reliability were determined using an ophthalmic fundus camera as the gold standard.
The participants' mean age was 51 with a standard deviation of ±11years, 213 (74.5%) were females, and the majority (93.4%) had Type 2 diabetes. The overall Sensitivity of PEEK retina for DR was 84% (95% CI 70.9-83.5), while the specificity was 79.9% (95% CI 76-83.5) with a positive predictive value (PPV) of 30.9% (95% CI 23.2-39.4) and a negative predictive value (NPV) of 97.9% (95% CI 95.9-99.1).
PEEK retina has high sensitivity and specificity, making it suitable for screening and diagnostic purposes. Therefore, we recommend the integration of the PEEK retina in the screening and diagnosis of DR in resource-limited settings.
糖尿病视网膜病变（DR）是糖尿病的主要并发症之一，也是全球失明的主要原因。在乌干达，城市人口中糖尿病的患病率约为 2.7%，农村地区为 1%。由于缺乏成本较低且易于使用的设备，许多糖尿病患者无法接受眼部检查，而初级眼科工作者可以使用这些设备。基于智能手机的眼底摄影可以实现廉价和移动的眼底检查。本研究旨在确定与标准眼底相机（蔡司 Visucam 200）相比，便携式眼部检查套件（PEEK）视网膜对 DR 的诊断的敏感性和特异性。
2020 年 1 月至 3 月，在基鲁杜国家转诊医院糖尿病诊所共对 286 名 1 型和 2 型糖尿病患者进行了检查。所有参与者均在眼科检查和瞳孔扩张后，使用 PEEK 视网膜和标准眼底相机进行眼底检查。使用眼科眼底相机作为金标准，确定 PEEK 视网膜的敏感性、特异性和可靠性。
参与者的平均年龄为 51 岁，标准差为±11 岁，213 名（74.5%）为女性，大多数（93.4%）患有 2 型糖尿病。PEEK 视网膜对 DR 的总体敏感性为 84%（95%CI 70.9-83.5），特异性为 79.9%（95%CI 76-83.5），阳性预测值（PPV）为 30.9%（95%CI 23.2-39.4），阴性预测值（NPV）为 97.9%（95%CI 95.9-99.1）。
PEEK 视网膜具有较高的敏感性和特异性，适用于筛查和诊断目的。因此，我们建议在资源有限的情况下，将 PEEK 视网膜整合到 DR 的筛查和诊断中。
