Photography or Ophthalmoscopy for Detection of Diabetic Retinopathy?

The U.K. National Screening Committee recommended digital fundus photography as the screening method of choice for diabetic retinopathy (DR). However, concerns have been expressed about replacing ophthalmoscopy with slit-lamp biomicroscopy by digital photography. These concerns included the possibility of missing peripheral and stereoscopic visible retinal lesions; increased chance of a technical failure compared with ophthalmoscopy, resulting in more reexaminations; and higher cost (1). New data from our study of 453 patients with diabetes, aged 31–86 years, highlight the need for a careful consideration of the retinal area photographed and the minimal resolution of images to detect DR.