DETECTION OF DIABETIC MACULAR EDEMA - NIDEK 3DX STEREOPHOTOGRAPHY COMPARED WITH FUNDUS BIOMICROSCOPY

PURPOSE: To assess the use of the Nidek 3Dx simultaneous stereophotogr aphy camera in diabetic patients, comparing the detection of clinicall y significant macular edema by fundus biomicroscopy to detection by th e Nidek 3Dx simultaneous fundus stereophotograph. METHODS: Two hundred eight eyes of 123 diabetic patients at the Wilmer Retinal Vascular Ce nter were examined for this prospective study between August 1993 and October 1993. Each patient was examined by one of three retina special ists by contact lens biomicroscopy for clinically significant macular edema and foveal center thickening. Nidek 3Dx fundus stereophotographs were obtained and graded independently for clinically significant mac ular edema and foveal center thickening by a fourth ophthalmologist ma sked from the clinical examination findings. Percent agreement, kappa statistic, and weighted kappa statistic were determined for the two di agnostic methods. RESULTS: One hundred eighty four (88%) of the 208 st ereophotographs were of sufficient quality to detect clinically signif icant macular edema; 175 (84%) of the 208 stereophotographs detected f oveal center thickening. The agreement between the clinician and the p hotographic grading, measured by weighted kappa, was 0.52 for clinical ly significant macular edema and 0.58 for foveal center thickening, re presenting fair to good agreement beyond chance, Agreement was improve d when normal fundus Nidek stereophotographs were available as standar ds for comparison. CONCLUSIONS: The Nidek 3Dx camera is suitable for p hotographic detection of clinically significant macular edema and may have a potential advantage over conventional cameras by achieving good -quality, gradable stereophotographs ina large proportion of photograp hed eyes.