STUDY OF THE EFFICIENCY OF A NONMYDRIATIC RETINAL CAMERA FOR THE DIAGNOSIS OF DIABETIC-RETINOPATHY

Diabetic retinopathy is one of the most important causes of blindness. Diabetic patients do not attend outpatient clinics with the necessary regularity for an early diagnosis of the most severe forms of retinop athy. A program was planned to compare the efficiency of a 45 degrees non-mydriatic retinal camera with a Polaroid(R) instant film versus bi omicroscopy with a 78D lens and reverse image ophthalmoscope (standard method) in the diagnosis of the presence and evolutive degree of reti nopathy. In a cross-sectional epidemiologic study a questionnaire was administered to 258 randomly selected diabetic patients, 129 with and 128 without retinopathy. Information was collected of demographics, vi sual acuity, diabetes and resources used with each method. The eye fun dus with the poorest visual acuity was examined to determine the prese nce and evolution of retinopathy with the two diagnostic methods. The photographic method had an overall sensitivity of 91.1%, a specificity of 89.7% and a level of agreement of 82% with the standard method. A cost-effective analysis revealed a decrease of 35.7% in the cost per t rue positive case detected with the photographic methods versus the st andard method. The 45 degrees non-mydriatic retinal camera had a simil ar efficiency to the standard method used in our setting for the diagn osis of diabetic retinopathy, which together with a lower cost per pat ient renders this method advisable for its use in medical settings tha t usually control for potential ophthalmologic complications resulting from diabetes mellitus.