Possible new method to improve detection of diabetic retinopathy: Polaroid non-mydriatic retinal photography.

Abstract

Two retinal cameras (Canon CR2 45NM and CR3 45NM) have recently become available and are capable of producing an instant colour photograph of a 450 field of retina, including the macula and optic disc, without dilatation of the pupils being necessary. The ability of each camera to detect diabetic retinopathy was compared with that of doctors in diabetic clinics using ophthalmoscopy during busy clinic hours. The CR3 was found to be considerably superior to the CR2 in terms of quality of photograph because it can use a smaller pupil. Overall, the detection rate ofthe camera was more than four times higher than that of ophthalmoscopy through undilated pupils and more than twice as high as that of ophthalmoscopy through dilated pupils. Lesions missed by ophthalmoscopy but detected by the camera included soft exudates and circinate rings of hard exudates, sometimes encroaching on the macula.

Screening for Diabetic Retinopathy: The wide-angle retinal camera

“…However, most previous studies suffered from methodological flaws, such as the absence of a reference standard (11)(12)(13)16,17,19) or the exclusion of ungradeable photographs from the analysis (11)(12)(13)(14)(15)(16)19). Furthermore, most studies have used the camera solely without pharmacological dilation (11)(12)(13)15,16,18,19). This study explores the performance characteristics of a wide-angle retinal camera used by primary care clinic personnel as an alternative to screening by an ophthalmologist, saving scarce ophthalmologieal resources for treatment.…”

“…Use of the wide-angle retinal camera has been explored in several studies and clinical reports (11)(12)(13)(14)(15)(16)(17)(18)(19). This camera has an infrared focusing system that permits use without pharmacological dilation.…”

Diabetic retinopathy screening: global and local perspective

“…The camera detection rate was 4 times higher through undilated pupils and more than twice as high through dilated pupils. 36 Although improved detection rates by ophthalmoscopy may improve clinical detection or diagnosis of DR, ophthalmoscopy can easily overlook signs of early DR in a busy diabetic clinics. 36 Various studies have compared single-field and two-field screening retinal photographs to seven-field stereo photographs.…”

“…36 Although improved detection rates by ophthalmoscopy may improve clinical detection or diagnosis of DR, ophthalmoscopy can easily overlook signs of early DR in a busy diabetic clinics. 36 Various studies have compared single-field and two-field screening retinal photographs to seven-field stereo photographs. [37][38][39][40] Single-field 45° photographs centred at the fovea, when compared with seven-field photographs, had a sensitivity of 74% to 86% and specificity of 92% to 95%.…”

25th RCOphth Congress, President's Session paper: 25 years of progress in medical retina

“…In addition, there was considerable debate as to how screening should be delivered, whether by fundus photography or direct ophthalmoscopy, with and without mydriasis, and who should be trained to perform it. [70][71][72][73][74][75] Many of these aspects were discussed at the Cambridge Ophthalmic Symposium in 1992, which was chaired by Dr Angus MacCuish a diabetic physician from Glasgow, who emphasised the needs for pupillary dilatation, for recruitment and training of personnel, and the importance of having quality control. 76 The development of DR screening in Europe had been accelerated by the St Vincent Declaration, in 1989, which set a target for reduction of new blindness by one-third, in the following 5 years.…”