Home  About us  Contact
 

DR Screening (dr + screening)

Distribution by Scientific Domains
Medical Sciences100%

Selected Abstracts

Retinal photography for diabetic retinopathy screening in Indigenous primary health care: the Inala experience

AUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH, Issue 2010
Geoffrey K. P. Spurling
Abstract Objective: We aimed to determine the impact of clinic based retinal photography on access to appropriate screening for diabetic retinopathy (DR). Design, setting and participants: We opportunistically recruited patients undergoing their annual diabetic cycle of care over a two year period in the urban Indigenous primary health care clinic. Data were collected on retinal outcomes, health variables and referral patterns. Main outcome measures: Access to appropriate screening and ophthalmic follow up, prevalence of DR, acceptability and feasibility of clinic-based retinal photography were the main outcome measures of this study. Results: One hundred and thirty-two of a possible 147 patients consented to participate. 30% of participants had DR. Appropriate screening and ophthalmic follow up increased six fold, from 20 to 124 participants, following the introduction of the retinal camera. Most participants felt very positive about DR screening. Conclusions: Primary care DR screening using retinal photography can improve access to DR screening for indigenous patients, reduce the burden on busy outpatient departments and should reduce visual loss. Policy-makers could contribute to screening sustainability by funding a medicare item-number for primary care based DR screening associated with the annual diabetic cycle of care. An upfront Practice Incentive Program (PIP) payment could offset set up costs. [source]

Validity of non-mydriatic cameras for screening and follow-up in diabetic retinopathy

ACTA OPHTHALMOLOGICA, Issue 2007
J IBANEZ
Purpose: To determine the validity of a non-mydriatic camera for screening and grading diabetic retinopathy (DR). To establish the number of photographs and the field width needed for a correct DR follow-up. Methods: A cross-sectional, observational study was carried out to assess the validity of the non-mydriatic Topcon TRC-NW6S retinograph. Validity proportions were calculated. Kappa analysis was made to determine the agreement with conventional fundoscopy exploration performed by indirect ophthalmoscopy and retinal biomicroscopy. One 45º single-field non-mydriatic digital photograph was taken in 82 eyes for DR screening. For DR grading, several combinations of retinal fields were photographed in 247 eyes, first without pupillary dilatation and later with mydriasis. Results: In DR screening, 88.2% sensitivity and 96.9% specificity were obtained, where 9% of the tests were invalid. In DR grading diagnosis, the kappa analysis showed close agreement (k>0.8) based on at least two 45º photographs with mydriasis. However, when attempting to detect macular edema (ME), the maximum kappa statistic obtained did not go above 0.71, showing 67% maximum sensitivity. The sensitivity for detecting derivable DR was similar to that obtained with indirect ophthalmoscopy (94-98%). Conclusions: The non-mydriatic retinograph is a valid instrument for DR screening only when taking one 45º non-mydriatic photograph per eye. However, given that the sensitivity for proliferative DR (PDR) was worse, when grading DR, we would recommend obtaining nine retinal photographs (mosaic) with mydriasis. Used in this way, the apparatus is extremely useful for detecting derivable DR cases. [source]

Victorian orthoptists' performance in the photo evaluation of diabetic retinopathy

CLINICAL & EXPERIMENTAL OPHTHALMOLOGY, Issue 8 2007
Zoran Georgievski BAppSc(Orth)Hons
Abstract Purpose:, The aim of this study was to investigate the effectiveness of orthoptists in detecting various grades of diabetic retinopathy (DR) and retinal pathology not directly associated with diabetes and to identify factors associated with best performance. Methods:, Forty-five orthoptists completed a survey comprising questions regarding their workplace experiences, plus a photo evaluation task with 36 digital fundus images. Results:, We found that orthoptists' overall performance in detecting the presence of abnormality in a series of DR images was high, the mean sensitivity being 86% and specificity 91%. The sensitivity was lower for images with minimal non-proliferative DR, but higher for those with mild,moderate and severe grades of DR. No factors were predictive of performance on the screening task. Conclusions:, Orthoptists performed extremely well, meeting the guidelines for DR screening recommended by National Health and Medical Research Council. The results indicate that orthoptists could potentially be used in DR screening models in Australia. [source]