Ahsan Shahid, Haseeb Uzma, Memon Muhammad Saleh, Bukhari Sadia, Mahmood Tauseef, Fahim Muhammad Faisal
Department of Biochemistry, Jinnah Medical & Dental College, Karachi, Pakistan.
Department of Ophthalmology, Al-Ibrahim Eye Hospital, Isra Postgraduate Institute of Ophthalmology, Karachi, Pakistan.
J Pak Med Assoc. 2022 Nov;72(11):2189-2192. doi: 10.47391/JPMA.4235.
To find out the validity of hand-held fundus camera by optometrist using slit lamp 90D biomicroscopy as reference standard for screening of diabetes retinopathy.
The observational cross-sectional study was conducted at the diabetic clinic of Al-Ibrahim Eye Hospital, Karachi, from August 2020 to May 2021, and comprised diabetics of either gender aged >16 years visiting the outpatient department. Un-dilated fundus photograph of both eyes were taken with non-mydriatic fundus camera. Pupils were then mid-dilated with one drop of tropicamide 1% before capturing retinal images by handheld fundus camera by another optometrist. Both the optometrists identified and recorded the presence and absence of diabetic retinopathy. Subsequently, a retinal specialist examined the fundus with slit lamp 90 D biomicroscopy. Data was analysed using SPSS 23.
Of the 500 subjects, 291(58.2%) were males and 209(41.8%) were females. The overall mean age was 54.49±9.16 years (range: 16-83 years). Of the 1000 eyes, fundus was not readable in 130(13%) by hand-held fundus camera, 296(29.6%) eyes by non-mydriatic fundus camera and 76(7.6%) eyes by slit lamp. Sensitivity and specificity of hand-held fundus camera compared to non-mydriatic fundus camera was 89.86% and 80.36%, respectively. In comparison with slit lamp, the sensitivity was 91.71% and specificity was 71.10%. Kappa statistic for diabetic retinopathy detection by hand-held fundus camera versus non-mydriatic fundus camera was 0.705, indicating substantial agreement. Kappa statistic for diabetic retinopathy detection with hand-held fundus camera with semi-dilated pupil was found to be a valid screening tool in the hand of optometrist for preliminary screening of diabetic retinopathy.
Handheld fundus camera with semi-dilated pupil was found to be a valid screening tool in the hand of optometrist for preliminary screening of diabetic retinopathy.
以裂隙灯90D生物显微镜检查作为参考标准，探究验光师使用手持眼底相机筛查糖尿病视网膜病变的有效性。
2020年8月至2021年5月在卡拉奇的易卜拉欣眼科医院糖尿病门诊进行了观察性横断面研究，纳入年龄大于16岁的门诊糖尿病患者，不限性别。使用非散瞳眼底相机拍摄双眼未散瞳眼底照片。然后滴一滴1%托吡卡胺使瞳孔中度散大，另一名验光师使用手持眼底相机拍摄视网膜图像。两位验光师均识别并记录糖尿病视网膜病变的有无。随后，视网膜专科医生使用裂隙灯90D生物显微镜检查眼底。使用SPSS 23进行数据分析。
500名受试者中，男性291名（58.2%），女性209名（41.8%）。总体平均年龄为54.49±9.16岁（范围：16 - 83岁）。1000只眼中，手持眼底相机有130只（13%）眼底不可读，非散瞳眼底相机有296只（29.6%）眼底不可读，裂隙灯有76只（7.6%）眼底不可读。与非散瞳眼底相机相比，手持眼底相机的灵敏度和特异度分别为89.86%和80.36%。与裂隙灯相比，灵敏度为91.71%，特异度为71.10%。手持眼底相机与非散瞳眼底相机检测糖尿病视网膜病变的Kappa统计量为0.705，表明一致性良好。发现手持眼底相机在散瞳状态下检测糖尿病视网膜病变是验光师进行糖尿病视网膜病变初步筛查的有效工具。
散瞳状态下的手持眼底相机是验光师进行糖尿病视网膜病变初步筛查的有效工具。
