[Validation of the electronic mailing of retinographs of diabetic patients in order to detect retinopathy in primary care]

(Validación de la transmisión por correo electrónico de la retinografía de pacientes diabéticos para detectar retinopatía en atención primaria.)

Full Abstract

OBJECTIVE:
Evaluate concordance in biomicroscopy evaluation of diabetic retinopathy degree among ophthalmologists. Validation of e-mail transmission of digital fundus photographs of type 2 diabetes patients as a method of diabetic retinopathy detection.

DESIGN:
Descriptive study.

SETTING:
Urban, primary health centre, and hospital.

PARTICIPANTS:
Type 2 diabetic patients selected of consecutive form when going to the primary health center (n=352).

MAIN MEASUREMENTS:
Parallel observer-blind evaluation of degree of retinopathy through biomicroscopy performed by ophthalmologists, against digital photographic images sent by e-mail taken by the family doctors. Concordance in the biomicroscopy among ophthalmologists was previously tested.

RESULTS:
Retinopathy was revealed in 25.70% of the retinographs; 10.44% was mild, 12.05% moderate, and 3.21% severe. Weighted kappa was 0.876 for biomicroscopy concordance. Sensitivity in detecting retinopathy is 76.6% and specificity 95.2%; 92.7% and 99.5% for ophthalmologist-derivable retinopathy. Sensitivity was 66.7% for non-mydriatic retinograph without dilation, 76.9% with elective dilation, and 85% with the mydriatic.

CONCLUSIONS:
Concordance in evaluation of retinopathy degree through biomicroscopy was "very good." This allows using a single ophthalmologist's exploration as a reference model. E-mail transmission of the photograph of the back of the eye in type 2 diabetic patients as a retinopathy detection method is feasible. Regardless of the type of retinograph used, the photographs should be taken on the dilated eye, as this significantly improves sensitivity.

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Author information

Author/s: Molina Fernández, Eduardo (E); Valero Moll, M Sacramento (MS); Pedregal González, Miguel (M); Calvo Lozano, José (J); Sánchez Ramos, José Luis (JL); Díaz Rodríguez, Eusebio (E); Uceda Torres, Rosario (R);

Affiliation: Medicina Familiar y Comunitaria, UDMFyC Huelva, Distrito Sanitario Huelva-Costa, Huelva, España. udhuelva(-atsign-)tiscali.es

Journal and publication information

Publication Type: English Abstract; Journal Article; Validation Studies

Journal: Atencion primaria / Sociedad Española de Medicina de Familia y Comunitaria (Aten Primaria), published in Spain. (Language: spa)

Reference: 2008-Mar; vol 40 (issue 3) : pp 119-23

Dates: Created 2008/03/31; Completed 2008/08/01;

PMID: 18373923, status: MEDLINE (last retrieval date: 11/6/2008)

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MeSH headings (categories)

This article was linked to the MESH Headings shown below.

Aged
Diabetes Mellitus, Type 2 - complications
Diabetic Retinopathy - radiography

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