Department of Ophthalmology, University of Padova, Padova, Italy.
IRCCS - Fondazione Bietti, Rome, Italy.
Eye (Lond). 2023 Oct;37(14):2994-2999. doi: 10.1038/s41433-023-02458-3. Epub 2023 Mar 1.
To compare the performance of a handheld fundus camera with standard 50° visual field to ultra-widefield (UWF) table-top fundus camera in diabetic retinopathy (DR) detection and grading.
Patients affected by diabetes mellitus and referred to our diabetic retinopathy clinic were enroled and underwent fundus photography in mydriasis. All photos were taken using the ultra-widefield table-top fundus camera Zeiss Clarus™ 500 (four fields per eye) and the Optomed Aurora® handheld fundus camera (3 fields per eye). The following parameters were analysed: the gradability of the images, the grade of DR, and diabetic maculopathy (DM), the presence of hypertensive retinopathy (HR) and the presence of other ocular diseases.
We enroled 759 eyes of 384 diabetic patients and analysed 5313 fundus photos. The handheld fundus camera obtained a sensitivity of 84.2% and specificity of 95.4% for referable cases. Moreover, it obtained, compared to UWF, an almost perfect agreement with linear weighting for DR, DM and HR (k = 0.877, k = 0.854, and k = 0.961, respectively). The lowest sensitivity was achieved for proliferative DR (58.7% sensitivity, 100% specificity).
Optomed Aurora® handheld fundus camera imaging showed a strong agreement compared to UWF in grading DR, considering all DR and DM grades, in mydriasis. However, the use of UWF imaging increases the detection of referable eyes.
比较手持式眼底相机与标准 50°视野超广角（UWF）桌面眼底相机在糖尿病视网膜病变（DR）检测和分级中的性能。
招募受糖尿病影响并到我们糖尿病视网膜病变诊所就诊的患者，并在散瞳下进行眼底摄影。所有照片均使用超广角桌面眼底相机 Zeiss Clarus™ 500（每只眼 4 个视野）和 Optomed Aurora®手持式眼底相机（每只眼 3 个视野）拍摄。分析以下参数：图像可分级性、DR 分级、糖尿病性黄斑病变（DM）、高血压性视网膜病变（HR）的存在和其他眼部疾病的存在。
我们共招募了 384 名糖尿病患者的 759 只眼，并分析了 5313 张眼底照片。手持式眼底相机对可转诊病例的敏感性为 84.2%，特异性为 95.4%。此外，与 UWF 相比，它在 DR、DM 和 HR 的线性加权方面具有近乎完美的一致性（k=0.877、k=0.854 和 k=0.961）。增殖性 DR 的敏感性最低（58.7%敏感性，100%特异性）。
在散瞳下，Optomed Aurora®手持式眼底相机成像在分级 DR 方面与 UWF 相比具有很强的一致性，考虑到所有 DR 和 DM 分级。然而，UWF 成像的使用增加了可转诊眼的检出率。
