Handheld fundus camera performance, image quality and outcomes of diabetic retinopathy grading in a pilot screening study
Handheld fundus camera performance, image quality and outcomes of diabetic retinopathy grading in a pilot screening study
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DOI：
10.1111/aos.14850
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发表时间：
2021-03-16
影响因子：
3.4
通讯作者：
Hautala, Nina
中科院分区：
文献类型：
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作者：
Kubin, Anna-Maria;Wirkkala, Joonas;Hautala, Nina
目的比较手持式眼底照相机和标准台式眼底照相机在糖尿病视网膜病变（DR）筛查中的性能和图像质量。DR分级的可靠性和诊断的准确性进行了评价，由眼科医生和摄影师reader.Materials和方法157例糖尿病患者，参加筛选或后续的DR，眼底照片进行了评价，在散瞳由Optomed极光和佳能或蔡司Visucam眼底照相机。影像质量和DR的严重程度由眼科医生和有经验的摄影师独立评价。结果对314只眼1884张眼底图像进行分析。53%的患眼不存在DR。10%有轻度非增殖性糖尿病视网膜病变（NPDR），16%中度NPDR，6%重度NPDR和16%增殖性糖尿病视网膜病变（PDR）。Aurora的DR分级结果与Canon或Zeiss的DR分级结果高度一致（kappa = 0.93，95%CI 0.91 - 0.94），眼科医生和摄影师之间的分级几乎完全一致（kappa = 0.96，95%CI 0.95 - 0.97）。极光的图像质量是足够的可靠的评估，根据两个等级在84-88%的cases.Conclusion的Optomed极光眼底相机似乎适合DR筛查。足够的图像质量和DR分级的高诊断准确性支持用于DR的较便宜且易于运输的筛查系统。由摄影师进行的即时图像分级将进一步改善和加速所有设置中的筛查过程。
Purpose To compare the performance and image quality of the handheld fundus camera to standard table-top fundus cameras in diabetic retinopathy (DR) screening. The reliability and diagnostic accuracy of DR grading performed by an ophthalmologist and a photographer reader were evaluated.Materials and methods 157 patients with diabetes, attending screening or follow-up of DR, were evaluated by fundus photographs taken in mydriasis by Optomed Aurora and Canon or Zeiss Visucam fundus cameras. The image quality and the severity of DR were evaluated independently by an ophthalmologist and experienced photographer. The sensitivity, specificity and reliability of the assessments were determined.Results 1884 fundus images from 314 eyes were analysed. In 53% of all eyes, DR was not present. 10% had mild non-proliferative diabetic retinopathy (NPDR), 16% moderate NPDR, 6% severe NPDR and 16% proliferative diabetic retinopathy (PDR). The DR grading outcomes by Aurora highly equalled to those of Canon or Zeiss (kappa = 0.93, 95% CI 0.91 to 0.94), and there was almost perfect agreement in grading between the ophthalmologist and photographer (kappa = 0.96, 95% CI 0.95 to 0.97). The image quality of Aurora was sufficient for reliable assessment according to both graders in 84-88% of the cases.Conclusion The Optomed Aurora fundus camera seems appropriate for DR screening. The sufficient image quality and high diagnostic accuracy for DR grading are supportive for a less expensive and easily transportable screening system for DR. Immediate image grading carried out by a photographer would further improve and speed up the screening process in all settings.