Teleophtalmology for Diabetic Retinopathy Screening

Several studies have suggested that telemedicine techniques may be used to screen patients for signs of diabetic retinopathy. The objective of this research is to use nonmydriatic digital fundus cameras to collect retinal images at remote sites that can be transmitted and interpreted by an ophthalmologist. The present study has examined the validity of using digital fundus images to recognize the presence and extent of retinopathy in diabetic patients. Nonmydriatic, nonstereoscopic digital fundus images were reviewed for signs of diabetic retinopathy and results were compared with those of clinical examination of the same patients. Thirty patients (57 eyes) have been examined to date. Seven were found to have image quality too poor to evaluate. Poor image quality was attributable to dense cataracts, miotic pupils or total retinal detachment. Interpretation of fundus by digital image and clinical ophthalmoscopy showed consistent results in recognition of diabetic retinopathy (k=O.65 (95% CI 0.42-0.83)); macular edema (k=0.88 (95% CI 0.64- 1.11)) and follow-up recommendations (k=0.61 (95% CI 0.31-0.90)). These preliminary results suggest that digital fundus images may accurately recognize diabetic retinopathy.