Screening for diabetic retinopathy using digital colour photography and oral fluorescein angiography

Purpose To evaluate digital colour photography and oral fluorescein angiogr aphy (OFA) for diabetic retinopathy screening. Methods Thirty-seven patients were selected from either a diabetic retinopa thy screening or a medical retina clinic. Three 45 degrees colour digital i mages and a single macula 45 degrees OFA image were taken from each eye. St andard sevenfield stereo photography with ETDRS grading was used as a gold standard for data comparison. The images were assessed by two graders and t he results of each method compared using the McNemar test. Results Five eyes had no diabetic retinopathy, 50 had background diabetic r etinopathy, 3 had pre-proliferative diabetic retinopathy, 11 had proliferat ive disease and 3 had quiescent posttreatment disease. Clinically significa nt macular oedema was present in 25 eyes and absent in 48. For grading diab etic retinopathy digital colour photography produced a sensitivity of 0.87 (specificity 0.83); OFA produced a sensitivity of 0.87 (specificity 0.80) ( p = 0.1). For the detection of diabetic maculopathy, the sensitivity of dig ital colour photography was 0.48 (specificity of 0.95) and for OFA was 0.87 (specificity 0.87) (p < 0.01). Conclusion This pilot study has shown that both digital colour photography and OFA compare well with conventional methods for diabetic retinopathy scr eening. The results encourage the further evaluation of OFA in the screenin g for diabetic maculopathy.