Application value of digital fudus photography in improving early intervention of hospitalized diabetic patients / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM:To observe the clinical value of digital nonmydriatic funds photography in screening diabetic retinopathy and early intervention of hospitalized diabetic patients. <p>METHODS: Totally 130 diabetic patients hospitalized in Department of Endocrinology of our hospital were selected from January 2015 to December 2016. All patients were underwent non-mydriatic digital fundus photography and fundus fluorescein angiography(FFA). <p>RESULTS: There were 82 eyes diagnosed as non-proliferative diabetic retinopathy(NPDR)and 28 eyes as proliferative diabetic retinopathy(PDR)by non-mydriatic digital fundus photography. There were 89 eyes diagnosed as NPDR and 29 eyes as PDR by FFA. Compared with the result of the gold standard, the Kappa value of non-mydriatic digital fundus photography was 0.87(>0.61), and the test was consistency. There was no significant difference between the two methods in the detection of diabetic retinopathy in different stages(<i>P</i>>0.05). The positive rate of diabetic retinopathy was significantly higher in patients with diabetes mellitus over 10a(<i>P</i><0.05). <p>CONCLUSION: Digital fundus photography is an effective method for early detection of DR in hospitalized diabetic patients. It is of great significance to reduce the blindness rate of diabetic retinopathy.

Early Detection of Glaucomatous Optic Nerve Abnormality by Nonmydriatic Digital Fundus Camera in a Routine Health Check-up

PURPOSE: To investigate the usefulness of the non-mydriatic digital fundus camera for detection of normal-tension glaucoma in routine health check-ups. METHODS: Among 1986 persons who received a routine health check-up in the Kangnam Health Care Center of Seoul National University Hospital (SNUH) from October to December 2003, 60 patients were referred to the Glaucoma Clinic of SNUH due to a suspicious optic nerve head or a retinal nerve fiber layer (RNFL) defect detected by a non-mydriatic digital fundus camera. The glaucoma work-up was performed, including Goldmann applanation tonometry, red free RNFL photography, Humphrey visual field (HVF), Stratus OCT and HRT II. RESULTS: Among 60 patients with a suspicious optic nerve head or suspected RNFL defect, 23 patients showed a retinal nerve fiber layer defect on red free RNFL photography. Those 23 patients had already demonstrated possible RNFL defects on photographs taken by a non-mydriatic digital fundus camera at their routine health check-up. In comparison with the normal, high PSD value of HVF (p=0.002), the narrow neuroretinal rim area shown by OCT (p=0.05) and HRT (p=0.02) were significantly different statistically. CONCLUSIONS: The non-mydriatic digital fundus camera can serve as a useful tool to screen normal-tension glaucoma in routine health check-up systems. However, the final diagnosis of glaucoma should be confirmed by red free RNFL photography and standard automated perimetry.

The Detection of Retinal Never Fiber Layer Defect by Modification of Non-mydriatic Digital Fundus Photograph

PURPOSE: To evaluate the efficiency of digital retinal nerve fiber layer (RNFL) photographs converted from a non-mydriatic digital fundus camera for detecting RNFL defects. METHODS: Ninety-five eyes were evaluated with both a non-mydriatic digital fundus photograph and a digital RNFL photograph by two glaucoma specialists independently. The red-free, monochrome modified digital fundus photograph was acquired from non-mydriatic digital fundus photographs using Photoshop 7.0. Whether a localized wedge-shaped or diffuse RNFL defect existed or not was evaluated on a non-mydriatic digital fundus photograph and a modified digital fundus photograph, and inter- and intraobserver agreement were also evaluated. Regarding the use of digital RNFL photographs as a standard method, we calculated the sensitivity, specificity, and positive and negative predictive values of the two types of photographs. RESULTS Interobserver agreement (Cohen's kappa values) about localized RNFL defects observable on digital RNFL photographs, non-mydriatic digital fundus photographs, and modified digital fundus photographs were 0.749, 0.634, and 0.793, respectively, but all were 0.417 or less with regard to diffuse RNFL defects. Regarding localized RNFL defects, the sensitivity, specificity, and positive and negative predictive values of modified digital fundus photographs were 85.7%, 95.5%, 85.7% and 94.1%, respectively, showing superiority to those of non-mydriatic digital fundus photographs. But, in cases of diffuse RNFL defect, the sensitivity and specificity of modified digital fundus photographs were 60.0% and 97.8%, respectively, indicating no superiority to non-mydriatic digital fundus photographs. CONCLUSIONS: The localized RNFL defect can be detected more efficiently with modified digital fundus photographs than non-mydriatic digital fundus photographs, but the diffuse RNFL defect cannot.

The Detection of Retinal Never Fiber Layer Defect by Modification of Non-mydriatic Digital Fundus Photograph

PURPOSE: To evaluate the efficiency of digital retinal nerve fiber layer (RNFL) photographs converted from a non-mydriatic digital fundus camera for detecting RNFL defects. METHODS: Ninety-five eyes were evaluated with both a non-mydriatic digital fundus photograph and a digital RNFL photograph by two glaucoma specialists independently. The red-free, monochrome modified digital fundus photograph was acquired from non-mydriatic digital fundus photographs using Photoshop 7.0. Whether a localized wedge-shaped or diffuse RNFL defect existed or not was evaluated on a non-mydriatic digital fundus photograph and a modified digital fundus photograph, and inter- and intraobserver agreement were also evaluated. Regarding the use of digital RNFL photographs as a standard method, we calculated the sensitivity, specificity, and positive and negative predictive values of the two types of photographs. RESULTS Interobserver agreement (Cohen's kappa values) about localized RNFL defects observable on digital RNFL photographs, non-mydriatic digital fundus photographs, and modified digital fundus photographs were 0.749, 0.634, and 0.793, respectively, but all were 0.417 or less with regard to diffuse RNFL defects. Regarding localized RNFL defects, the sensitivity, specificity, and positive and negative predictive values of modified digital fundus photographs were 85.7%, 95.5%, 85.7% and 94.1%, respectively, showing superiority to those of non-mydriatic digital fundus photographs. But, in cases of diffuse RNFL defect, the sensitivity and specificity of modified digital fundus photographs were 60.0% and 97.8%, respectively, indicating no superiority to non-mydriatic digital fundus photographs. CONCLUSIONS: The localized RNFL defect can be detected more efficiently with modified digital fundus photographs than non-mydriatic digital fundus photographs, but the diffuse RNFL defect cannot.