ArticleThe British journal of ophthalmology2024
One-field, two-field and five-field handheld retinal imaging compared with standard seven-field Early Treatment Diabetic Retinopathy Study photography for diabetic retinopathy screening.
Article in The British journal of ophthalmology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.
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Who cites it
5 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Comparative diagnostic accuracy of photographic methods for detecting diabetic retinopathy: A systematic review and meta-analysis.European journal of ophthalmology · 2026Pooled it
- Clinical setting-dependent diagnostic accuracy of artificial intelligence and store-and-forward diabetic retinopathy screening: a systematic review and meta-analysis.NPJ digital medicine · 2026Article
- Bioelectrical Impedance Profiling to Estimate Neuropathic and Vascular Risk in Patients with Type 2 Diabetes Mellitus.Diagnostics (Basel, Switzerland) · 2025Article
- Comparison of the Aireen System with Telemedicine Evaluation by an Ophthalmologist - A Real-World Study.Clinical ophthalmology (Auckland, N.Z.) · 2025Article
- Addressing Technical Failures in a Diabetic Retinopathy Screening Program.Clinical ophthalmology (Auckland, N.Z.) · 2024Article
Corrections and comments
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Authors and funding
10 authors.
Funding
Abstract
BACKGROUND/
aimsTo determine agreement of one-field (1F, macula-centred), two-field (2F, disc-macula) and five-field (5F, macula, disc, superior, inferior and nasal) mydriatic handheld retinal imaging protocols for the assessment of diabetic retinopathy (DR) as compared with standard seven-field Early Treatment Diabetic Retinopathy Study (ETDRS) photography.
methodsProspective, comparative instrument validation study. Mydriatic retinal images were taken using three handheld retinal cameras: Aurora (AU; 50° field of view (FOV), 5F), Smartscope (SS; 40° FOV, 5F), and RetinaVue (RV; 60° FOV, 2F) followed by ETDRS photography. Images were evaluated at a centralised reading centre using the international DR classification. Each field protocol (1F, 2F and 5F) was graded independently by masked graders. Weighted kappa (Kw) statistics assessed agreement for DR. Sensitivity (SN) and specificity (SP) for referable diabetic retinopathy (refDR; moderate non-proliferative diabetic retinopathy (NPDR) or worse, or ungradable images) were calculated.
resultsImages from 225 eyes of 116 patients with diabetes were evaluated. Severity by ETDRS photography: no DR, 33.3%; mild NPDR, 20.4%; moderate, 14.2%; severe, 11.6%; proliferative, 20.4%. Ungradable rate for DR: ETDRS, 0%; AU: 1F 2.23%, 2F 1.79%, 5F 0%; SS: 1F 7.6%, 2F 4.0%, 5F 3.6%; RV: 1F 6.7%, 2F 5.8%. Agreement rates of DR grading between handheld retinal imaging and ETDRS photography were (Kw, SN/SP refDR) AU: 1F 0.54, 0.72/0.92; 2F 0.59, 0.74/0.92; 5F 0.75, 0.86/0.97; SS: 1F 0.51, 0.72/0.92; 2F 0.60, 0.75/0.92; 5F 0.73, 0.88/0.92; RV: 1F 0.77, 0.91/0.95; 2F 0.75, 0.87/0.95.
conclusionWhen using handheld devices, the addition of peripheral fields decreased the ungradable rate and increased SN and SP for refDR. These data suggest the benefit of additional peripheral fields in DR screening programmes that use handheld retinal imaging.
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