{"title":"SCREENING AND MONITORING OF DIABETIC RETINOPATHY IN COMMUNITY CARE: The Effectiveness of Single-Field Versus Multifield Fundus Photography.","authors":"Xin He, Xinchen Deng, Zhong Lin, Liang Wen, Weihe Zhou, Xiang Xu, Shiqi Hu, Yuanbo Liang, Yu Wang, Jia Qu, Cong Ye","doi":"10.1097/IAE.0000000000004311","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to evaluate the effectiveness of single-field fundus photography for diabetic retinopathy (DR) screening and monitoring versus six-field imaging in community settings.</p><p><strong>Methods: </strong>Adults aged ≥30 years with Type 2 diabetes from 15 communities in Northeast China were recruited for this prospective cohort study (n = 2,006 at baseline and n = 1,456 at follow-up). Participants underwent both single-field and six-field digital fundus photography at baseline and follow-up visits (mean duration of 21.2 ± 3.2 months). Photographs were graded using international standards. Agreement in DR severity grading, referral recommendations, and detection of DR progression were compared between single-field and six-field fundus photography.</p><p><strong>Results: </strong>Single-field grading showed substantial agreement with multifield grading in classifying DR severity (81.9% identical at baseline, 80.6% at follow-up, Gwet AC1 0.79 and 0.77). For referring eyes with moderate nonproliferative DR or worse, single-field grading had ∼70% sensitivity and 100% specificity compared with six-field grading. Single-field grading identified 74.9% or 79.7% of eyes progressing or regressing by six-field grading, respectively.</p><p><strong>Conclusion: </strong>Single-field fundus photography demonstrated reasonable effectiveness for DR screening and monitoring in a community setting, supporting its use for improving access to DR detection. However, reduced sensitivity compared with multifield imaging should be acknowledged.</p>","PeriodicalId":54486,"journal":{"name":"Retina-The Journal of Retinal and Vitreous Diseases","volume":" ","pages":"318-324"},"PeriodicalIF":2.3000,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Retina-The Journal of Retinal and Vitreous Diseases","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/IAE.0000000000004311","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"OPHTHALMOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Purpose: This study aimed to evaluate the effectiveness of single-field fundus photography for diabetic retinopathy (DR) screening and monitoring versus six-field imaging in community settings.
Methods: Adults aged ≥30 years with Type 2 diabetes from 15 communities in Northeast China were recruited for this prospective cohort study (n = 2,006 at baseline and n = 1,456 at follow-up). Participants underwent both single-field and six-field digital fundus photography at baseline and follow-up visits (mean duration of 21.2 ± 3.2 months). Photographs were graded using international standards. Agreement in DR severity grading, referral recommendations, and detection of DR progression were compared between single-field and six-field fundus photography.
Results: Single-field grading showed substantial agreement with multifield grading in classifying DR severity (81.9% identical at baseline, 80.6% at follow-up, Gwet AC1 0.79 and 0.77). For referring eyes with moderate nonproliferative DR or worse, single-field grading had ∼70% sensitivity and 100% specificity compared with six-field grading. Single-field grading identified 74.9% or 79.7% of eyes progressing or regressing by six-field grading, respectively.
Conclusion: Single-field fundus photography demonstrated reasonable effectiveness for DR screening and monitoring in a community setting, supporting its use for improving access to DR detection. However, reduced sensitivity compared with multifield imaging should be acknowledged.
期刊介绍:
RETINA® focuses exclusively on the growing specialty of vitreoretinal disorders. The Journal provides current information on diagnostic and therapeutic techniques. Its highly specialized and informative, peer-reviewed articles are easily applicable to clinical practice.
In addition to regular reports from clinical and basic science investigators, RETINA® publishes special features including periodic review articles on pertinent topics, special articles dealing with surgical and other therapeutic techniques, and abstract cards. Issues are abundantly illustrated in vivid full color.
Published 12 times per year, RETINA® is truly a “must have” publication for anyone connected to this field.