NONMYDRIATIC FUNDUS PHOTOGRAPHY - A VIABLE ALTERNATIVE TO FUNDOSCOPY FOR IDENTIFICATION OF DIABETIC-RETINOPATHY IN AN ABORIGINAL POPULATIONIN RURAL WESTERN-AUSTRALIA

Purpose: To evaluate the Canon CR5-45NM non-mydriatic fundus camera (C anon, Kanagawa, Japan) for identifying retinopathy and the need for la ser treatment in a population of Aboriginal patients with diabetes mel litus in rural Western Australia. Methods: Diabetic Aboriginal patient s were photographed through undilated pupils using a Canon CR5-45NM no nmydriatic fundus camera, after which ophthalmoscopy was performed usi ng indirect ophthalmoscopy through dilated pupils. The examining ophth almologist recorded the presence of retinopathy and the need for laser treatment. A proportion of patients were rephotographed through dilat ed pupils. Photographs were reviewed by a second ophthalmologist who e valuated the quality of the image, the presence of retinopathy and the need for laser treatment. Results of fundus photographs and ophthalmo scopy were compared. Results: Three hundred and twenty-eight eyes in 1 64 Aboriginal patients were examined. The mean patient age was 48.2 ye ars (range 16-81 years) and the mean duration of diabetes was 7.5 year s (range 1-35 years). Seventy-four eyes (22.6%) were diagnosed with re tinopathy using combined examination techniques, 44 (59.5%) of which w ere identified by ophthalmoscopy and 55 (74.3%) by photography. Thirty -five eyes were deemed to need treatment, 18 (51.4%) of which were ide ntified by ophthalmoscopy and 30 (85.7%) by photography. Kappa coeffic ient measurement for agreement for presence of retinopathy and need fo r referral was 0.41 and 0.53, respectively Photograph quality was sign ificantly improved following pupil dilation. Conclusions: The Canon CR 5-45NM non-mydriatic fundus camera was relatively good at identifying diabetic retinopathy and could usefully be applied within a screening programme for treatable disease within this population.