The Application Of The Nonmydriatic Ultrawide Field Retinal Imaging In Large-scale Diabetic Retinopathy Screening

Purpose To investigate the diagnostic value of nonmydriatic ultrawide field retinal imaging versus nonmydriatic 2-field 45°digital fundus photography In large-scale diabetic retinopathy(DR) screening.Methods Based on Santan hospital of tianjin nankai district, Seven hundred and thirty-three type 2 diabetes mellit Ils patients(1466 eyes) of district Standardized management underwent nonmydriatic ultrawide field retinal imaging and nonmydriatic 2-field 45°digital fundus photography examination. Two independent readers graded images respectively to determine the stage of DR. A third masked retina specialist adjudicated discrepancies.Results Based on ultrawide field imaging, the results were as follows: no DR(NDR)(n=1062 [74.0%]), mild nonproliferative DR(NPDR)( n=48 [3.3%]), moderate NPDR(n=206 [15.1%]), severe NPDR(n=57 [4.0%]), and proliferative DR(PDR)( n=19[1.3%]). 32(2.2%)eyes was ungradable. Based on digital fundus Photography,the results were as follows: NDR(n=1080 eyes [75.3%]), mild NPDR(n=36[2.51%]),moderate NPDR(n=175 [12.2%]), severe NPDR(n=53 [3.7%]), and PDR(n=6[0.4%]). 84( 5.9%) eye was ungradable. Compared with digital fundus photography, ultrawide field imaging for detecting DR, the kappa value was 0.87, the sencitivity was 98% and the specificity was 95%.For screening severe NPDR and PDR, the kappa value was 0.94,the sencitivity was 100%, and the specificity was99%.Conclusions In rapid large-scale DR screening, there was high consistency between nonmydriatic ultrawide field images and nonmydriatic 2-field 45°digital fundus photography. Nonmydriatic ultrawide field imaging was proven to be more comprehensive and precise, has better adaptability and is an effective method for DR screening; Based on community hospitals, Joint community hospital diabetes management for screening DR is an effective model.