A Report on the Use of Technician Ophthalmoscopy Combined with the Use of the Canon Non‐mydriatic Camera in Screening for Diabetic Retinopathy in the Community

Jacob, J; Stead, Jonathan; Sykes, John; Taylor, David; Tooke, John E.

doi:10.1111/j.1464-5491.1995.tb00506.x

Cited by 32 publications

(30 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…There is evidence indicating that narrow angles in isolation, are a poor predictor of the likelihood of mydriatic-induced acute glaucoma 424;425 . In a 4-year review of patients treated for AACG in Birmingham, only 2.6% were due to diagnostic pupil dilation, an approximate risk by diagnostic mydriasis of 1/20,000 421 , similar to the population study data 27;417;421;424 . There are no reports of AACG being precipitated by tropicamide used alone.…”

Section: Adverse Effects Of Pupil Dilationmentioning

confidence: 81%

See 1 more Smart Citation

Adherence to diabetic eye examination guidelines in Australia: the National Eye Health Survey

Foreman

Keel

Xie

et al. 2017

Medical Journal of Australia

View full text Add to dashboard Cite

Section: Adverse Effects Of Pupil Dilationmentioning

confidence: 81%

“…Reported adverse effects include the potential of acute angle-closure glaucoma (AACG) 421 , cardiovascular side effects, plus transient discomfort and blurring. Case reports of allergic contact dermatitis from eye drops are documented 422 .…”

Section: Adverse Effects Of Pupil Dilationmentioning

confidence: 99%

Adherence to diabetic eye examination guidelines in Australia: the National Eye Health Survey

Foreman

Keel

Xie

et al. 2017

Medical Journal of Australia

View full text Add to dashboard Cite

“…In contrast to the screening methods of the other population studies, [8][9][10][11][12] which involved multi-field photography and clinical examination by ophthalmologists, we combine single-field photography with screening technician ophthalmoscopy. 7 The impact of adding screener ophthalmoscopy to the Polaroid imaging in our screening set-up is such that a sensitivity of 95% and specificity of 97% can be achieved for the detection of STDR in a direct comparison with 7-fields stereo photography grading by the Hammersmith Grading Centre. 13 It had previously been suggested that the incidence of STDR in a diabetic population would decrease with successive rounds of screening.…”

Section: Discussionmentioning

confidence: 99%

“…7 Patients with diabetes were identified from the diabetic registry kept by each individual general practice. All patients were then invited to attend screening clinics at their practices, including those who were already under the supervision of hospital ophthalmologists.…”

Section: The Screening Programmementioning

confidence: 99%

Longitudinal study of a cohort of people with diabetes screened by the Exeter Diabetic Retinopathy Screening Programme

Ling¹,

Ramsewak²,

Taylor³

et al. 2002

Eye

View full text Add to dashboard Cite

Purpose To evaluate the long-term outcome of a cohort of people with diabetes screened by the Exeter Diabetic Retinopathy Screening Programme. Method The cohort comprised of diabetic patients from nine market town General Practices around Exeter who first attended the diabetic retinopathy screening programme in 1992. Screening was carried out by a combination of dilated fundoscopy by a screening technician and a single 45؇ Polaroid photograph of each eye. The prevalence of diabetic retinopathy at the baseline, the incidence of sight threatening diabetic retinopathy (STDR) in the next two rounds of screenings, and the long-term visual outcome are described. Results The cohort consisted of 775 patients (104 Type I, 517 Type II non-insulinrequiring and 154 Type II insulin-requiring). The mean age was 72.1 years (15-100), with mean disease duration of 13.0 years (1-79). Baseline prevalence was as follows: background retinopathy: 21.4%, proliferative: 2.8%, clinically significant macular oedema: 6.1%. The incidence of proliferative disease was 2.20% and 2.25% respectively in the next two rounds of screening (P Ͼ 0.05, 2 test). The incidence of clinically significant macular oedema was also constant over next two rounds of screening, at 4.79% and 5.18% respectively (P Ͼ 0.05, 2 test). Ninety-five (12.3%) patients were deceased and a further 179 (23%) patients were lost to follow-up by the third round. Only two patients with newly diagnosed STDR suffered deterioration of visual acuity to 6/60 or worse as a result of diabetic retinopathy. ConclusionThe incidence of STDR remained constant throughout the period of screening, reflecting the chronic progressive nature of the disease. Significant numbers of patients were lost to follow-up. Screening seemed effective in preserving vision in those patients with newly diagnosed STDR.

show abstract

“…16 retinopathy per eye and quality level of each colour transparency. The quality level was based on EURODIAB Since up to 50 % of people with diabetes rarely or never attend hospital diabetic clinics 17 the role of the criteria 25 as follows: general practitioner (GP), [18][19][20] ophthalmic opticians, 21,22 Level 1: Excellent-full field photography, picture defiand technicians 23 as primary screeners has been examnition good, lesions easily discernible as present or ined. Whereas effectiveness of screening by GPs using not present.…”

Section: Introductionmentioning

confidence: 99%

Screening for diabetic retinopathy by general practitioners: ophthalmoscopy or retinal photography as 35 mm colour transparencies?

et al. 1998

View full text Add to dashboard Cite

In order to assess the relative ability of general practitioners (GPs) to detect diabetic retinopathy (DR), especially sight‐threatening diabetic retinopathy (STDR) by direct ophthalmoscopy or by examining, on a separate occasion, retinal images as 35 mm colour transparencies, a South and Mid Wales primary care‐based study was performed in four general practices (six GPs). The participating GPs were provided with standardized training and equipment. Both methods were compared to the ‘reference’ grade of DR provided by the Diabetic Retinopathy Reading Centre (London), based on the same retinal images. Ophthalmoscopy and retinal photography (Canon CR4 45NM) with mydriasis were all practice based. The clinical assessments were based on a protocol developed for screening for DR in Europe. A total of 996 people with diabetes were identified, representing a prevalence of known diabetes of 2.1 %. After exclusions on medical grounds, 897 patients were available for screening, of whom 605 (68 %) were photographed. Based on the retinal images, the reference centre identified DR in 43 % and STDR in 14.4 %. In total, 597 valid comparisons between GPs and the reference centre were obtained; of these, 462 (77 %) were high quality photographs which were used in subsequent analysis. The sensitivity for detecting any DR increased from 62.6 % (95 % CI 55.9–69.4) with ophthalmoscopy to 79.2 % (95 % CI 73.6–84.9) using retinal photographs, specificity remaining essentially unchanged at 75.0 (95 % CI 69.5–80.5) and 73.5 % (95 % CI 68.0–79.1) with the positive predictive value (PPV) increasing from 67.2 (95 % CI 60.4–74.0) to 71.0 % (95 % CI 65.0–77.0), respectively. The detection of STDR sensitivity increased from 65.7 (95 % CI 54.4–77.1) with ophthalmoscopy alone to 87.3 % (95 % CI 79.4–95.2) based on retinal photographs with specificity falling from 93.8 (95 % CI 91.4–96.3) to 84.8 % (95 % CI 81.2–88.5) and PPV from 65.7 (95 % CI 54.4–77.1) to 51.2 % (95 % CI 42.1–60.3), respectively. We conclude that the use of standardized 35 mm colour transparency retinal photographs for screening by trained GPs in a primary care setting achieves an acceptable detection rate (>87 %) for STDR, contrasting with ophthalmoscopy alone (66 %), which was below the proposed UK standard of 80 %. © 1998 John Wiley & Sons, Ltd.

show abstract

A Report on the Use of Technician Ophthalmoscopy Combined with the Use of the Canon Non‐mydriatic Camera in Screening for Diabetic Retinopathy in the Community

Cited by 32 publications

References 12 publications

Adherence to diabetic eye examination guidelines in Australia: the National Eye Health Survey

Adherence to diabetic eye examination guidelines in Australia: the National Eye Health Survey

Longitudinal study of a cohort of people with diabetes screened by the Exeter Diabetic Retinopathy Screening Programme

Screening for diabetic retinopathy by general practitioners: ophthalmoscopy or retinal photography as 35 mm colour transparencies?

Contact Info

Product

Resources

About