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PubMed2005

Comparison of Colvard pupillometer and infrared digital photography for measurement of the dark-adapted pupil diameter.

PURPOSE: To investigate the accuracy of pupil diameter measurement using the Colvard pupillometer and to determine the learning curve for inexperienced examiners. SETTING: Texas Tech University Health Sciences Center, Lubbock, Texas, USA. METHODS: In this population study, subjects with normal pupillary behavior were tested by 1 of 2 investigators (examiner A, examiner B). After 5 minutes of dark adaptation at 1 lux, digital infrared pupil photography of the right eye was performed, followed by measurement of the horizontal pupil diameter and vertical pupil diameter with the Colvard pupillometer. The photographs were digitally analyzed to determine the horizontal and vertical pupil diameters. During phase I of the study, examiners were masked to the results of infrared pupil photography; during phase II, they reviewed the infrared pupil photography results after each testing session. Bland-Altman plots were created to detect measurement bias; results were graphed by subject test sequence to assess learning. A test difference of less than +/-0.5 mm was considered clinically acceptable. RESULTS: Fifty-nine subjects were tested in phase I, of whom 39 had adequate infrared pupil photography for analysis; 40 were tested in phase II, of whom 34 were included. The mean age of the analyzed subjects was 27 years (range 18 to 44 years). For all subjects, the infrared pupil photography median horizontal pupil diameter was 7.09 mm +/- 0.75 (SD) (range 5.44 to 8.79 mm); the median vertical pupil diameter was 7.22 +/- 0.79 mm (range 5.45 to 9.10 mm). Examiner A initially had a negative bias (Colvard pupillometer value less than infrared pupil photography value) for both horizontal and vertical pupil diameter measurements, which resolved during phase I after 23 subjects were tested; 18 of the final 19 subjects tested (11 phase I, 8 phase II) showed a test difference of less than 0.5 mm for all readings. The pupil diameter did not affect the bias. Examiner B had a strong positive bias that persisted throughout the study. Testing 26 subjects in 5 sessions during phase II did not improve the accuracy. During the final testing session, 3 of 8 subjects had a test difference of 0.5 mm or more in at least 1 dimension. The pupil diameter did not affect the bias. CONCLUSION: The Colvard pupillometer is susceptible to user errors causing unidirectional bias and seems to have a steep and variable learning curve.

Adolescent↗
PubMed2004

Single-field fundus photography for diabetic retinopathy screening: a report by the American Academy of Ophthalmology.

OBJECTIVE: To evaluate whether single-field fundus photography can be used as a screening tool to identify diabetic retinopathy for referral for further ophthalmic care. METHODS: A MEDLINE search of the peer-reviewed literature was conducted in June 2001 for the years 1968 to 2001 and updated in September 2003, yielding 145 articles. The search was limited to articles published in English. The Cochrane Library of clinical trials was also investigated. The authors reviewed the abstracts of these articles and selected 63 of possible clinical relevance for review by the panel. Of these 63 articles, the panel selected 32 for the panel methodologist to review and rate according to the strength of evidence. RESULTS: Three of the 32 articles reviewed were classified as level I evidence, and 4 were classified as level II evidence. Evidence from level I studies demonstrates that as a tool to detect vision-threatening retinopathy, single-field fundus photography interpreted by trained readers has sensitivity ranging from 61% to 90% and specificity ranging from 85% to 97% when compared with the gold standard reference of stereophotographs of 7 standard fields. When compared with dilated ophthalmoscopy by an ophthalmologist, single-field fundus photography has sensitivity ranging from 38% to 100% and specificity ranging from 75% to 100%. CONCLUSIONS: Single-field fundus photography is not a substitute for a comprehensive ophthalmic examination, but there is level I evidence that it can serve as a screening tool for diabetic retinopathy to identify patients with retinopathy for referral for ophthalmic evaluation and management. The advantages of single-field fundus photography interpreted by trained readers are ease of use (only one photograph is required), convenience, and ability to detect retinopathy. Further studies will be required to assess the implementation of single-field photography-based programs to confirm the clinical and cost-effectiveness of these techniques in improving population visual outcomes. Future research also should include establishing standardized protocols and satisfactory performance standards for diabetic retinopathy screening programs.

Academies and Institutes↗
PubMed2002

Retinal nerve fiber layer analysis: relationship between optical coherence tomography and red-free photography.

PURPOSE: Comparison of retinal nerve fiber layer (RNFL) thickness measurements using optical coherence tomography (OCT) to the clinical standard red-free photography (evaluated semiquantitatively), in relation to functional visual field damage in primary open-angle glaucoma (POAG) patients, ocular hypertensives, and POAG suspects. METHODS: Concurrent, cross-sectional study. In four age-matched groups (42 patients with early to moderate POAG, 34 ocular hypertensives, 22 POAG suspects, and 25 normal controls), RNFL was assessed with OCT, standardized red-free photographic scoring method and standard achromatic perimetry. RESULTS: OCT RNFL thickness decreases with increased RNFL damage (detected with red-free photography). The global average OCT RNFL thickness correlated significantly with the photographic total RNFL score (r = .650, P = .0001). Both OCT and photographic scoring system were able to find significantly thinner RNFL in the glaucoma group as compared with normals (P = .0001 for both), ocular hypertensives (P = .0001 for both), and suspects (P = .0001 for both). However, neither OCT nor photography could significantly differentiate between ocular hypertensives, suspects, and normals. Both OCT and photography were significantly correlated with VF loss. For the percentage of VF points depressed <5%, the correlation was highest for OCT (r = -0.615 for OCT and r = -0.476 for photography). OCT had a higher diagnostic accuracy than photography (86% and 77%, respectively). CONCLUSION: For RNFL thickness measurements, the presence of high correlations between OCT, photographic scores, and functional visual field loss suggest the validity of OCT measurements. The higher diagnostic accuracy of OCT RNFL measurements suggests its potential advantage for detection of early cases of glaucoma.

Cross-Sectional Studies↗
PubMed2000

A comparison of optical coherence tomography and retinal nerve fiber layer photography for detection of nerve fiber layer damage in glaucoma.

PURPOSE: To compare optical coherence tomography (OCT) retinal nerve fiber layer (RNFL) thickness measurements with established methods for assessment of glaucomatous damage using RNFL photography and visual field testing. DESIGN: Cross-sectional study. PARTICIPANTS: Fifty-eight eyes of 58 healthy volunteer ocular hypertensive patients, glaucoma suspect patients, and glaucoma patients were included. METHODS: Optical coherence tomography 3.4-mm diameter circular scans were obtained within 3 months of RNFL photography and standard achromatic visual field testing. Three independent observers graded RNFL photographs using two standardized protocols. For each method, superior and inferior arcuate bundles were scored separately, and interobserver and intraobserver variation was measured. Standard achromatic visual field mean deviation in the superior and inferior hemifields was compared with RNFL damage as assessed by photography and OCT RNFL thickness measurements. MAIN OUTCOME MEASURES: Visual field mean deviation and severity of glaucomatous RNFL damage as assessed by photography. RESULTS: Optical coherence tomography RNFL thickness decreased with increasing RNFL damage as assessed by photography using both methods of photographic assessment. Standard achromatic perimetry mean deviation was significantly associated with OCT RNFL thickness (R(2) = 35%-43%) and RNFL photography severity score (R(2) = 18%-29%). CONCLUSIONS: These results suggest that the OCT shows promise for providing quantitative measures of RNFL thickness for diagnosing and monitoring glaucoma.

Adult↗
PubMed2003

The effectiveness of screening for diabetic retinopathy by digital imaging photography and technician ophthalmoscopy.

AIMS: To evaluate the introduction of a community-based non-mydriatic and mydriatic digital photographic screening programme by measuring the sensitivity and specificity compared with a reference standard and assessing the added value of technician direct ophthalmoscopy. METHODS: Study patients had one-field, non-mydriatic, 45 degrees digital imaging photography prior to mydriatic two-field digital imaging photography followed by technician ophthalmoscopy. Of these patients, 1549 were then examined by an experienced ophthalmologist using slit lamp biomicroscopy as a reference standard. The setting was general practices in Gloucestershire. Patients were selected by randomizing groups of patients (from within individual general practices) and 3611 patients were included in the study. Patients for reference standard examination were recruited from groups of patients on days when the ophthalmologist was able to attend. The main outcome measure was detection of referable diabetic retinopathy (DR) as defined by the Gloucestershire adaptation of the European Working Party guidelines. RESULTS: For mydriatic digital photography, the sensitivity was 87.8%, specificity was 86.1% and technical failure rate was 3.7%. Technician ophthalmoscopy did not alter these figures. For non-mydriatic photography, the sensitivity was 86.0%, specificity was 76.7% and technical failure rate was 19.7%. CONCLUSIONS: Two-field mydriatic digital photography is an effective method of screening for referable diabetic retinopathy. Non-mydriatic digital photography has an unacceptable technical failure rate and low specificity.

Adolescent↗
PubMed1992

Variable angle retinal nerve fibre layer photography: a review.

Optic disc and retinal nerve fibre layer (RNFL) photography have been an integral part of the routine screening of glaucoma patients, ocular hypertensives and glaucoma suspects in Perth since 1979. During this period 60 degrees, 40 degrees, 30 degrees and 8 degrees angles of view were examined for potential use in RNFL photography. The degree of dilation and media opacity is highly variable in glaucoma patients because of the age group involved and the miotic therapy. It was found that the 30 degree angle of view gave the most consistent results for routine RNFL photography. Ocular hypertensives tended to be of a lower mean age and 40 degrees wide angle photography was possible but required two different photographic techniques and was not continued. Both 60 degrees and high-magnification RNFL photography are currently used only with selected patients for teaching and demonstration. A modified Hasselblad 120 roll film camera was used for high-resolution RNFL photography. The Hasselblad adaptors, high-resolution results and comparisons with wide-angle RNFL photographs are illustrated in this paper.

Fundus Oculi↗
PubMed2002

Does direct ophthalmoscopy improve retinal screening for diabetic eye disease by retinal photography?

AIMS: To identify whether after performing retinal photography, direct ophthalmoscopy can improve the yield of screening for the detection of sight-threatening diabetic eye disease (STDED). METHODS: Patients (n = 408) who had previously received both dilated direct ophthalmoscopy by a diabetologist and retinal photography graded by a diabetologist within 3 months of each other were included. The results of the other screening modality were not available to the grader/screener. The first 308 patients were consecutive attendees at the clinic who fulfilled the study criteria and 100 were selected because they were identified as having potential STDED by either one of these modalities. An ophthalmologist using slit lamp biomicroscopy then examined patients identified with potential STDED. RESULTS: In 357 (88%) patients there was agreement between the two modalities about whether referral to an ophthalmologist was required (kappa 0.62). Retinal photography identified 38 patients for referral to ophthalmology which ophthalmoscopy missed. Of these, the ophthalmologist agreed that STDED was present in 32 (84%) and four patients required early laser. Ophthalmoscopy identified 13 patients for referral who were not identified by photography. Of these, the ophthalmologist agreed with the diabetologist that STDED was present in seven (54%) and one patient required early laser. CONCLUSION: Ophthalmoscopy may identify the occasional patient with diabetes who has STDED which is missed by retinal photography. For a systematic retinal screening programme, adding ophthalmoscopy to retinal photography will increase false-positive referrals and is likely to detect only a few extra patients requiring laser.

Chi-Square Distribution↗
PubMed1998

Effectiveness of non-mydriatic retinal photography and direct ophthalmoscopy in detecting diabetic retinopathy.

This is a prospective study to compare the effectiveness of non-mydriatic photography with that of direct ophthalmoscopy in screening for diabetic retinopathy in 153 patients attending a hospital clinic in Hong Kong. Retinal photography under physiological mydriasis and direct ophthalmoscopy of patients with dilated pupils were compared with the ophthalmologists' examination results as a reference standard. The prevalence of diabetic retinopathy in this sample population was 15%. The sensitivity of detecting diabetic retinopathy by retinal photography was higher than that of direct ophthalmoscopy (64% versus 41%; 95% confidence interval of difference, 1.2%- 44.3%). Of five patients who had serious retinopathy, retinal photography failed to detect the disease in two; direct ophthalmoscopy failed to detect the disease in all five patients. Specificities of retinal photography and direct ophthalmoscopy were 90% (95% confidence interval, 84%-96%) and 93% (95% confidence interval, 88%-97%), respectively. We conclude that retinal photography is significantly more effective than direct ophthalmoscopy in detecting diabetic retinopathy. In addition, the non-mydriatic camera is easy to use and is the preferred method of screening.

Journal Article↗
PubMed2004

Diagnostic accuracy of patients in performing skin self-examination and the impact of photography.

OBJECTIVE: To determine the sensitivity and specificity of skin self-examination (SSE) to detect new and changing moles with and without the aid of baseline digital photographs in patients with dysplastic nevi. DESIGN AND INTERVENTION: Patients had baseline digital photography and mole counts of their back, chest, and abdomen and were instructed to perform a baseline SSE. Print copies of the images were provided to the patient. Following the baseline examination, the appearance of existing moles was altered and new moles were created using cosmetic eyeliner. The number of moles altered and/or created totaled approximately 10% of each patients' absolute mole count. SETTING AND PATIENTS: Fifty patients with 5 or more dysplastic nevi from the outpatient clinic at Memorial Sloan-Kettering Cancer Center, New York, NY. MAIN OUTCOME MEASURE: Skin self-examinations with and without access to the baseline photographs to identify the number of new and altered moles. RESULTS: The sensitivity and specificity of SSE for detection of both altered and new moles without photography were 60.2% and 96.2%, respectively. Skin self-examination with photography yielded a sensitivity and specificity of 72.4% and 98.4%, respectively. The findings were similar when stratified by site (back vs chest or abdomen). The sensitivity and specificity for new moles were higher compared with altered moles. CONCLUSIONS: Access to baseline photography improved the diagnostic accuracy of SSE on the back and chest or abdomen and improved detection of changing and new moles. Our results suggest that baseline digital photography in tandem with SSE may be effective in improving the diagnostic accuracy of patients performing SSE.

Adult↗
PubMed1998

Screening for diabetic retinopathy: the utility of nonmydriatic retinal photography in Egyptian adults.

Although regular screening for diabetic retinopathy with ophthalmoscopy or retinal photography is widely recommended in the United States and Europe, few reports of its use in developing countries are available. We compared the performance of screening by retinal photography with that of indirect ophthalmoscopy by using data from a population-based survey of diabetes and its complications in Egypt. During that project, 427 persons with diabetes underwent an eye examination and fundus photography with a non-mydriatic camera through a dilated pupil. Data from the examinations of the right eye of each patient are presented. Ninety-two (22%) of the 427 retinal photographs were ungradable; in 58 eyes (63%), this was due to media opacity (42 eyes with cataract, 3 with corneal opacity, and 13 with both). Agreement between retinal photography and indirect ophthalmoscopy was poor (kappa = 0.33; 95% CI = 0.27-0.39) and primarily due to the large number of eyes (n = 79) with ungradable photographs that could be graded by ophthalmoscopy. None of these eyes was judged by ophthalmoscopy to have sight-threatening retinopathy. Fifty-four photographs were diagnosed with greater retinopathy than found on ophthalmoscopy. Retinal photography with the nonmydriatic camera through a dilated pupil is a useful method to screen for diabetic retinopathy in most adults in Egypt. However, such screening strategies have limited use in older persons and in persons with corneal disease or cataract.

Adult↗
PubMed2004

Digital photography: a new method for estimating food intake in cafeteria settings.

OBJECTIVE: The primary objective of this study was to test the comparability of digital photography and visual estimation procedures for estimating food intake. RESEARCH METHODS AND PROCEDURES: The study sample included 71 breakfast meals and 59 lunch meals eaten in a university cafeteria during a single day. A total of 66 different foods were employed as test foods that could be selected by the students. Food selections and plate waste, as estimated by digital photography and visual estimation, were compared. For digital photography, three observers independently estimated portion sizes of each food item based upon digital photographs. One observer estimated portion sizes in the cafeteria setting, using visual estimation, a method that has been validated in other studies. RESULTS: To test the accuracy of the two procedures for measuring food intake, the estimates of food weights derived from both procedures were compared using Bland-Altman regression. In comparison to visual estimation, the digital photography method yielded comparable estimates of food selections, plate waste, and total food intake for seven of nine comparisons. The two methods of estimating food portions yielded comparable results for most (78%) types of foods. The two methods also yielded similar variability. DISCUSSION: These findings suggest that the digital photography method is an alternative to the traditional method of estimating food intake via direct observation.

Energy Intake↗
PubMed2000

Light-induced damage of the retina through slit-lamp photography.

BACKGROUND: I report on two patients who suffered severe loss of visual acuity after slit-lamp photography of the anterior eye segment. METHODS: Both patients were pseudophakic and pictures were taken to document the degree of posterior capsule opacification via retroillumination with dilated pupils. Both patients had excellent visual acuity at the time of photography was taken and experienced reduction of to hand movement afterwards. A Zeiss 75 SL device was used for the slit-lamp photography. In cooperation with Carl Zeiss Jena the slit lamp was investigated. RESULTS: Ophthalmoscopy and angiography after photography discovered a central macular defect, similar to a photocoagulation. The visual acuity did not recover. CONCLUSION: Under certain circumstances slit-lamp photography of the anterior eye segment can lead to severe light-induced damage of the retina.

Aged↗
PubMed2006

Evaluation of aerial photography for predicting trends in structural attributes of Australian woodland including comparison with ground-based monitoring data.

The accurate assessment of trends in the woody structure of savannas has important implications for greenhouse accounting and land-use industries such as pastoralism. Two recent assessments of live woody biomass change from north-east Australian eucalypt woodland between the 1980s and 1990s present divergent results. The first estimate is derived from a network of permanent monitoring plots and the second from woody cover assessments from aerial photography. The differences between the studies are reviewed and include sample density, spatial scale and design. Further analyses targeting potential biases in the indirect aerial photography technique are conducted including a comparison of basal area estimates derived from 28 permanent monitoring sites with basal area estimates derived by the aerial photography technique. It is concluded that the effect of photo-scale; or the failure to include appropriate back-transformation of biomass estimates in the aerial photography study are not likely to have contributed significantly to the discrepancy. However, temporal changes in the structure of woodlands, for example, woodlands maturing from many smaller trees to fewer larger trees or seasonal changes, which affect the relationship between cover and basal area could impact on the detection of trends using the aerial photography technique. It is also possible that issues concerning photo-quality may bias assessments through time, and that the limited sample of the permanent monitoring network may inadequately represent change at regional scales.

Australia↗
PubMed2003

Comparison of digital photography to weighed and visual estimation of portion sizes.

OBJECTIVE: The primary goal was to test the validity of digital photography for measuring food portion sizes compared with weighed foods and with direct visual estimation. SAMPLES: A total of 60 test meals consisting of 10 different portion sizes from six different university cafeteria menus were prepared and weighed. DESIGN: Food selections and plate waste, as estimated by digital photography and direct visual estimation, were compared with weighed foods. For each method, three observers independently estimated portion sizes of each food. Observers expressed the portion sizes as a percentage of a standard serving. These percentages were multiplied by the weight of the standard portion to yield estimated weights. Statistical analyses To test validity, the estimates of food weights derived from both methods were compared with weighed foods using correlations and were compared with each other using Bland-Altman regression analysis. RESULTS: For the digital photography and direct visual estimation methods, estimates of the portion sizes for food selections, plate waste, and food intake were highly correlated with weighed foods. Both methods tended to yield small overestimates or underestimates. Bland-Altman regression found the two estimation methods to yield comparable results (bias less than 1.5 g). APPLICATIONS/CONCLUSIONS: These findings support the validity of the digital photography method for measuring portion sizes. Digital photography may be most useful for measuring food intake in settings that allow for the direct observation of food selections and plate waste but require minimum disruption of the eating environment, and allow unhurried estimates of portion sizes.

Diet Records↗
PubMed2004

Identification of fixation location with retinal photography in macular degeneration.

BACKGROUND: Identification of fixation location is an integral part of low vision assessment and subsequent rehabilitation. We performed a study to determine whether retinal photography is able to identify fixation location in eyes with age-related macular degeneration (AMD). METHODS: In a prospective, observational case series, consecutive patients with AMD attending a low-vision clinic underwent monocular fixation attempts at a fixation target of a standard ophthalmic fundus camera. Inclusion criteria included AMD with documented macular disease, low vision in both eyes and best-corrected visual acuity of 20/50 to 20/200 in the tested eye. Retinal photography was used to document retinal location of attempted fixation. Macular perimetry was used to confirm acceptable fixation maintenance behaviour. Outcome measures included acceptable fixation maintenance during retinal photography and retinal location of fixation pattern. RESULTS: Twenty-one patients (14 women and 7 men with an average age of 78 [range 53 to 86] years) met the inclusion criteria. In nine cases both eyes met the study criteria, for a total of 30 eyes. Of the 30 eyes, 24 (80%) had acceptable fixation maintenance with retinal photography (p = 0.939). In 17 (71%) of the 24 eyes the retinal fixation location was superior to the macular scar. INTERPRETATION: The results suggest that retinal photography may provide a reliable method to identify retinal location of fixation in eyes with AMD.

Aged↗
PubMed1997

Polarized light photography enhances visualization of inflammatory lesions of acne vulgaris.

BACKGROUND: Polarized light photography has been used to selectively differentiate surface from subsurface features of photoaged skin. OBJECTIVE: Our purpose was to compare acne assessments obtained from clinical evaluations with assessments from photographs obtained with flash photography and with perpendicular polarized light photography. METHODS: Assessments of acne with the Cunliffe scale were made of 32 subjects. Retrospective evaluations of standard and perpendicular polarized light photographs were made in a blinded fashion by a panel of evaluators. RESULTS: Visualization of inflammatory acne lesions was enhanced with perpendicular polarized light photography, with clear delineation of erythematous borders. Acne assessments with the use of a Cunliffe scale were significantly higher (p = 0.001) from perpendicular polarized light photographs than for clinical evaluations. CONCLUSION: Polarized light photography enhances visualization of inflammatory acne lesions in a manner not possible with conventional flash photographs, permitting accurate evaluation of the extent of disease and the effectiveness of therapy.

Acne Vulgaris↗
PubMed2000

A comparison between one- and two-field 60 degree fundus photography when screening for diabetic retinopathy.

PURPOSE: To compare the severity level of diabetic retinopathy obtained when assessed from two versus only one 60 degrees photographic field using colour transparencies and red-free, black-and-white photographs. To compare the areal coverage of these two photographic strategies to that of seven-field 30 degrees photography. METHODS: Two ophthalmologists graded photographs of 74 eyes of 74 type I and II diabetes patients. Inter-method agreement was expressed in percentages and using kappa statistics and scatter-diagrams. The comparison of the approximate photographic areal coverage was done from diagrams using planimetry. RESULTS: The severity level of retinopathy when judged from two photographic fields was more severe in 13.5% (Grader 1) and in 16.2% (Grader 2) from colour transparencies and in 13.5% (Grader 1) and in 14.9% (Grader 2) from red-free black-and-white prints, as compared to assessments from only one field. Kappa values (0.84-0.86) for inter-method agreement for five pooled retinopathy levels revealed good agreement. Neither grader missed retinopathy requiring clinical assessment or treatment (levels > or = 47) when minimal retinopathy (levels 14-20) was detected using only one 60 degrees colour slide or red-free photograph. A second optic disc-centred field provided valuable additional information when more severe retinopathy lesions (levels > or = 30) were detected in the macula-centred field. One macula-centred 60 degrees photograph covered 60% and two 60 degrees photographs 80% of the area covered by seven-field 30 degrees photography. Two-field 60 degrees photography covers areas left outside seven-field 30 degrees photography. CONCLUSION: We propose the use of one macula-centred 60 degrees photograph when screening for the first lesions of diabetic retinopathy. After they have been found two-field 60 degrees photography is recommended.

Adolescent↗
PubMed2000

Screening for diabetic retinopathy using digital colour photography and oral fluorescein angiography.

PURPOSE: To evaluate digital colour photography and oral fluorescein angiography (OFA) for diabetic retinopathy screening. METHODS: Thirty-seven patients were selected from either a diabetic retinopathy screening or a medical retina clinic. Three 45 degrees colour digital images and a single macula 45 degrees OFA image were taken from each eye. Standard seven-field stereo photography with ETDRS grading was used as a gold standard for data comparison. The images were assessed by two graders and the results of each method compared using the McNemar test. RESULTS: Five eyes had no diabetic retinopathy, 50 had background diabetic retinopathy, 3 had pre-proliferative diabetic retinopathy, 11 had proliferative disease and 3 had quiescent posttreatment disease. Clinically significant macular oedema was present in 25 eyes and absent in 48. For grading diabetic retinopathy digital colour photography produced a sensitivity of 0.87 (specificity 0.83); OFA produced a sensitivity of 0.87 (specificity 0.80) (p = 0.1). For the detection of diabetic maculopathy, the sensitivity of digital colour photography was 0.48 (specificity of 0.95) and for OFA was 0.87 (specificity 0.87) (p < 0.01). CONCLUSION: This pilot study has shown that both digital colour photography and OFA compare well with conventional methods for diabetic retinopathy screening. The results encourage the further evaluation of OFA in the screening for diabetic maculopathy.

Adult↗