ArticleDiabetology & metabolic syndrome2015
Comparison between binocular indirect ophthalmoscopy and digital retinography for diabetic retinopathy screening: the multicenter Brazilian Type 1 Diabetes Study.
Article in Diabetology & metabolic syndrome, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02927561 (Automated Diagnostic Test for Diabetic Retinopathy in Brazilian Mass Screening), which is not on this map. Cited by 25 papers, 1 of them a synthesis that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Automated Diagnostic Test for Diabetic Retinopathy in Brazilian Mass Screening
Who cites it
25 citing papers in PubMed, 1 synthesis or guideline pooled it, 46 citations in OpenAlex.
- Pooled it
- Performance of a Retinal Imaging Camera With On-Device Intelligence for Primary Care: Retrospective Study.JMIR formative research · 2025Article
- Type 1 diabetes in Brazil: a narrative overview of the Brazilian Type 1 Diabetes Study Group.Diabetology & metabolic syndrome · 2025Review
- Image quality assessment of retinal fundus photographs for diabetic retinopathy in the machine learning era: a review.Eye (London, England) · 2024Review
- Transition from an in-person to a telemedicine diabetic retinopathy screening program.Arquivos brasileiros de oftalmologia · 2024Article
- Potency of teleophthalmology as a detection tool for diabetic retinopathy.Scientific reports · 2023Article
- Use of digital retinography to detect vascular changes in pre-diabetic patients: a cross-sectional study.Diabetology & metabolic syndrome · 2023Article
- Clinical validation of a smartphone-based retinal camera for diabetic retinopathy screening.Acta diabetologica · 2023Article
- Single retinal image for diabetic retinopathy screening: performance of a handheld device with embedded artificial intelligence.International journal of retina and vitreous · 2023Article
- A Systematic Review of Digital Ophthalmoscopes in Medicine.Clinical ophthalmology (Auckland, N.Z.) · 2023Review
- Diabetic Retinopathy Screening Using Artificial Intelligence and Handheld Smartphone-Based Retinal Camera.Journal of diabetes science and technology · 2022Article
- Article
- Human Leukocyte Antigens class II (HLA II) gene profile from an admixed population of patients with type 1 diabetes with severe diabetic retinopathy: a nested case-control study in Brazil.Diabetology & metabolic syndrome · 2021Article
- Diabetic retinopathy screening in urban primary care setting with a handheld smartphone-based retinal camera.Acta diabetologica · 2020Article
- Genomic ancestry as a risk factor for diabetic retinopathy in patients with type 1 diabetes from an admixed population: a nested case-control study in Brazil.Acta diabetologica · 2020Article
- Diabetic retinopathy screening and the COVID-19 pandemic in Brazil.Arquivos brasileiros de oftalmologia · 2020Article
- Cost-utility Analysis of Opportunistic and Systematic Diabetic Retinopathy Screening Strategies from the Perspective of the Brazilian Public Healthcare System.Applied health economics and health policy · 2020Article
- Retinal exams requested at Primary Care Unit: indications, results and alternative strategies of evaluation.Einstein (Sao Paulo, Brazil) · 2020Article
- Diabetic Retinopathy May Indicate an Increased Risk of Cardiovascular Disease in Patients With Type 1 Diabetes-A Nested Case-Control Study in Brazil.Frontiers in endocrinology · 2019Article
- Current epidemiology of diabetic retinopathy in patients with type 1 diabetes: a national multicenter study in Brazil.BMC public health · 2018Article
Corrections and comments
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Authors and funding
12 authors at 6 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDiabetic retinopathy is the main cause of preventable blindness in the economically active population in western countries. Diabetic retinopathy screening is effective in preventing blindness and can be performed through various diagnostic methods. Our objective is to compare binocular indirect ophthalmoscopy (BIO) to telemedicine protocols of digital retinography for diabetic retinopathy screening in a large and heterogenous type 1 diabetes population in a developing country.
methodsData from 1266 Type 1 Diabetes Mellitus patients from a Brazilian multicenter study were analyzed. Patients underwent BIO and digital retinography, non-mydriatic and mydriatic. Images were sent to a reading center in a telemedicine protocol. Agreement between the different methods was calculated with kappa statistic for diabetic retinopathy and maculopathy classification. Clinical outcome was either observation or referral to specialist.
resultsAgreement between BIO and mydriatic retinography was substantial (kappa 0.67-0.74) for diabetic retinopathy observation vs referral classification. Agreement was fair to moderate (kappa 0.24-0.45) between retinography and BIO for maculopathy. Poor mydriasis was the main obstacle to image reading and classification, especially on the non-mydriatic strategy, occurring in 11.9 % of right eyes and 16.9 % of left eyes.
conclusionMydriatic retinography showed a substantial agreement to BIO for diabetic retinopathy observation vs referral classification. A significant amount of information was lost on the non-mydriatic technique because of poor mydriasis. We recommend a telemedicine-based diabetic retinopathy screening strategy with digital mydriatic retinography, preferably with 2 fields, and advise against non-mydriatic retinography in developing countries.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.