American Journal of Ophthalmology
Volume 137, Issue 3 , Pages 445-452 , March 2004

Screening for sight-threatening diabetic retinopathy: comparison of fundus photography with automated color contrast threshold test

  • Gek L. Ong, PhD

      Affiliations

    • Sussex Eye Hospital, Brighton, United Kingdom (G.L.O., R.S.N., M.C., A.G.C.)
    • Department of Engineering and Design, University of Sussex, Falmer, Brighton, United Kingdom (G.L.O., L.G.R.)
    • Corresponding Author InformationInquiries to Gek L. Ong, PhD, Sussex Eye Hospital, Eastern Road, Brighton, United Kingdom, BN2 5BF; fax: (+44) 1273-693674
    • ,
  • Lionel G. Ripley, PhD

      Affiliations

    • Department of Engineering and Design, University of Sussex, Falmer, Brighton, United Kingdom (G.L.O., L.G.R.)
    • ,
  • Richard S. Newsom, MD, FRCOphth

      Affiliations

    • Sussex Eye Hospital, Brighton, United Kingdom (G.L.O., R.S.N., M.C., A.G.C.)
    • ,
  • Matthew Cooper, FRCOphth

      Affiliations

    • Sussex Eye Hospital, Brighton, United Kingdom (G.L.O., R.S.N., M.C., A.G.C.)
    • ,
  • Anthony G. Casswell, FRCOphth

      Affiliations

    • Sussex Eye Hospital, Brighton, United Kingdom (G.L.O., R.S.N., M.C., A.G.C.)

,Accepted 5 October 2003.

References 

  1. Foulds WS, McCuish AC, Barrie T, et al.  Diabetic retinopathy in the west of Scotland (Its detection and prevalence, and the cost-effectiveness of a proposed screening programme). Health Bull (Edinb). 1983;41:318–326
  2. Evans J, Rooney C, Ashwood F, Dattani N, Wormald R. Blindness and partial sight in England and Wales (April 1990-March 1991). Health Trends. 1996;28:5–12
  3. Department of Health Consultative Documents, UK (1991)
  4. British Multicentre Study Group . Photocoagulation for proliferative diabetic retinopathy (A randomised controlled trial using the Xenon arc). Diabetologia. 1982;26:109–115
  5. Early Treatment Diabetic Retinopathy Study Research Group . Early treatment diabetic retinopathy study design and baseline patient characteristics (ETDRS report number 7). Ophthalmology. 1991;98:741–756
  6. Early Treatment Diabetic Retinopathy Study Research Group . Early photocoagulation for diabetic retinopathy (ETDRS report number 9). Ophthalmology. 1991;98:766–785
  7. Rohan TE, Frost CD, Wald NJ. Prevention of blindness by screening for diabetic retinopathy;a quantitative assessment. BMJ. 1989;299:1198–1201
  8. Hammond CJ, Shackleton J, Flanagan DW, Herrtage J, Wade J. Comparison between an ophthalmic optician and an ophthalmologist in screening for diabetic retinopathy. Eye. 1996;10:107–112
  9. Leese GP, Tesfaye S, Dengler-Harles M, et al.  Screening for diabetic eye disease by optometrist using slit lamps. J Royal Col Physicians Lon. 1997;31:65–69
  10. Buxton MJ, Sculpher MJ, Ferguson BA, et al.  Screening for treatable diabetic retinopathy (A comparison of different methods). Diabetic Med. 1991;8:371–377
  11. Sussman E, Tsiaras W, Soper KA. Diagnosis of diabetic eye disease. JAMA. 1982;247:3231–3234
  12. Harding SP, Broadbent DM, Neoh C, White MC, Vora J. Sensitivity and specificity of photography and direct ophthalmoscopy in screening for sight threatening eye disease (The Liverpool diabetic eye study). BMJ. 1995;311:1131–1135
  13. Evans PM, Purewal TS, Hopper A, Slater H, Jones DR, O'Hare. Screening for diabetic retinopathy in primary care: Retinal photography alone can be used efficiently and effectively to exclude those with sight threatening lesions. J Med Screening 1997;4:174–176
  14. Newsom RSB, Moate B, Casswell AG. Screening for diabetic retinopathy using colour photography and oral fluorescein angiography. Eye. 2000;14:579–582
  15. Taylor DJ, Fisher J, Jacob J, Tooke JE. The use of digital cameras in a mobile retinal screening environment. Diabetic Med. 1999;16:680–687
  16. Diabetes Control and Complications Trial Research Group . Colour photography versus fluorescein angiography in the diabetes control trial. Arch Ophthalmol. 1987;105:1344–1351
  17. Moss S, Meuer SM, Klein R, Hubbard LD, Brothers RJ, Klein BEK. Are seven standard photographic fields necessary for classification of diabetic retinopathy?. Invest Ophthalmol Vis Sci. 1989;30:823–828
  18. Singer DE, Nathan DM, Fogel HA, Schachat AP. Screening for diabetic retinopathy. Ann Intern Med. 1991;116:660–671
  19. Sculpher MJ, Buxton MJ, Ferguson BA, Humphreys JE, Altman JF, Spiegelhalter DJ. A relative cost effective analysis of different methods of screening for diabetic retinopathy. Diabetic Med. 1991;8:644–650
  20. Sculpher MJ, Buxton MJ, Ferguson BA, et al.  Screening for diabetic retinopathy (A relative cost-effectiveness analysis of alternative modalities and strategies). Health Economics. 1992;1:39–51
  21. Witkin SR, Klein R. Ophthalmologic care for persons with diabetes. JAMA. 1984;260:2534–2537
  22. Sprafka JM, Fritsche TL, Baker R, Kurth D, Whipple D. Prevalence of undiagnosed eye disease in high-risk diabetic individuals. Arch Ophthalmol Intern Med. 1990;150:857–861
  23. Brechner RJ, Cowie CC, Howie LJ, Herman WH, Will JC, Harris MI. Ophthalmologic examination among adults with diagnosed diabetes mellitus. JAMA. 1993;269:1714–1718
  24. Jones RB, Larizgoita I, Casado L, Barrie T. How effective is the referral chain for diabetic retinopathy. Diabetic Med. 1989;6:262–266
  25. Clark JB, Grey RHB, Lim KKT, Burns-Cox CJ. Loss of vision before ophthalmic referral in blind and partially sighted diabetics in Bristol. Br J Ophthalmol. 1994;78:741–744
  26. Ong GL, Ripley LG, Newsom RSB, Casswell AG. Assessment of colour vision as a screening test for sight-threatening diabetic retinopathy, prior to loss of vision. Br J Ophthalmol. 2003;87:747–752
  27. Kohner EM, Porta M. Protocol for screening and treatment of diabetic retinopathy in Europe. Eur J Ophthalmol. 1991;1:45–54
  28. Cornsweet TN. The staircase method in psychophysics. Am J Psychol. 1962;75:485–491
  29. Sparrow JM, Bron AJ, Phelps-Brown NA, Neil HAW. Biometry of the crystalline lens in early-onset diabetes. Br J Ophthalmol. 1990;74:654–660
  30. Lutze M, Bresnick G. Lenses of diabetic patients “yellow” at an accelerated rate similar to older normals. Invest Ophthalmol Vis Sci. 1991;32:194–199
  31. Hardy KJ, Scarpello JH, Foster DH, Moreland JD. Effect of diabetes associated increase in lens optical density on colour discrimination in insulin dependent diabetes. Br J Ophthalmol. 1994;78:754–756
  32. Holladay JT, Prager TC. Mean visual acuity. Am J Ophthalmol. 1991;111:372–374
  33. Bloch DA, Kraemer HC. 2 × 2 kappa coefficients (Measures of agreement or association). Biometrics. 1989;45:269–287
  34. Kraemer HC. Assessment of 2 × 2 associations (Generalization of signal-detection methodology). Am Stat. 1988;42:37–49
  35. Leese GP, Ahmed S, Newton RW, et al.  Use of mobile screening unit for diabetic retinopathy in rural and urban areas. BMJ. 1993;106:187–189
  36. Rogers D, Bitner-Glindzics M, Harris C, Yudkin JS. Non-mydriatic retinal photography as a screening service for general practitioners. Diabetic Med. 1990;7:65–67
  37. O'Hare JP, Hopper A, Madhaven C, et al.  Adding retinal photography to screening for diabetic retinopathy (A prospective study in primary care). BMJ. 1996;312:672–682
  38. Leese GP, Newton RW, Jung RT, Haining W, Ellingford A. Screening for diabetic retinopathy in a widely spaced population using non-mydriatic fundus photography in a mobile unit. Diabetic Med. 1992;9:459–462
  39. Williams R, Nussey S, Humphry R, Thompson G. Assessment of non-mydriatic fundus photography in detection of diabetic retinopathy. BMJ. 1986;293:1140–1142
  40. Working Party of the British Diabetic Association. Retinal photography screening for diabetic eye disease. A British Diabetic Association Report, 1997. Available at: http://www.diabetes.org.uk/
  41. Klein R, Klein BEK, et al.  Diabetic retinopathy as detected using ophthalmoscopy, a non-mydriatic camera and a standard fundus camera. Ophthalmology. 1985;92:485–491
  42. Mohan R, Kohner EM, Aldington SJ. Evaluation of a non-mydriatic camera in Indian and European diabetic patients. Br J Ophthalmol. 1988;72:841–845
  43. Jones D, Dolben J, Owens DR, Vora JP, Young S. Non-mydriatic Polaroid photography in screening for diabetic retinopathy (Evaluation in a clinical setting). BMJ. 1988;296:1029–1030
  44. Bresnick GH, Condit R, Palta M, Korth K, Groo A, Syrjala S. Association of hue-discrimination loss and diabetic retinopathy. Arch Ophthalmol. 1985;103:317–324
  45. Greenstein VC, Sarter B, Hood D, Noble K, Carr R. Hue discrimination and s-cone pathway sensitivity in early diabetic retinopathy. Invest Ophthalmol Vis Sci. 1990;31:1008–1014
  46. Tregear SJ, Knowles PJ, Ripley LG, de Alwis DV, Reffin JP, Casswell AG. Automated tritan discrimination sensitivity (a new clinical technique for the effective screening of severe diabetic retinopathy). Int J Psychophysiology. 1994;16:188–191
  47. Tregear SJ, Knowles PJ, Ripley LG, Casswell AG. Chromatic-contrast thresholds impairment in diabetes. Eye. 1997;11:537–546
  48. Fong DS, Barton FB, Bresnick GH. Impaired colour vision associated with diabetic retinopathy (Early treatment diabetic retinopathy study report number 15). Am J Ophthalmol. 1999;128:612–617
  49. Maár N, Tittl M, Sturr M, et al.  A new colour vision arrangement test to detect functional changes in diabetic macular oedema. Br J Ophthalmol. 2001;85:45–51
  50. Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics. 1997;33:159–174
  51. Early Treatment Diabetic Retinopathy Study Group . Photocoagulation for diabetic macular oedema (ETDRS report No. 1). Arch Ophthalmol. 1985;103:1796–1806
  52. Ryder REJ, Close CF, Gray MD, Souten H, Gibson JM, Taylor KG. Fail-safe diabetic retinopathy detection and categorisation by experienced ophthalmic opticians combining dilated retinal photography with ophthalmoscopy. Diabetic Med. 1994;11(Suppl 2):S44

PII: S0002-9394(03)01281-9

doi: 10.1016/j.ajo.2003.10.021

American Journal of Ophthalmology
Volume 137, Issue 3 , Pages 445-452 , March 2004

Article Tools