Accuracy Of Direct Ophthalmoscopy Used By The Trainee Evaluated By Fundus Photography.

Purpose: To analyse the effectiveness of direct ophthalmoscopy used by the trainee in detecting and screening various fundus diseases by fundus photography.Method: After completing a direct ophthalmoscopy training as postgraduate students majoring in ophthalmology, 1 trainee was randomly chosen from the 4 trainees as the examiner using direct ophthalmoscopy in this study. 514 volunteers aged 50 or above were recruited and the study was conducted on 1,003 eyes from July 2010 to August 2010 in Nanao Island, Shantou. The fundus of the volunteers was examined by the trainees using direct ophthalmoscopy under undilated condition. Then, 30°color fundus photographs were taken under dilated condition. Finally the fundus photos were analyzed by a retinal specialist and the results were set as reference standards. The diagnostic correlation between direct ophthalmoscopy and the fundus photos in detecting glaucoma, diabetic retinopathy, hypertensive retinopathy, epiretinal membrane, retinitis pigmentosa, high myopia, central/branch retinal vein occlusion, age-related macular degeneration was evaluated. The data were analyzed with Kappa values, specificity, diagnostic accuracy, area under the ROC curve and Logistic regression model.Results: The diagnostic efficiency of direct ophthalmoscopy and fundus photography in detecting retinitis pigmentosa, central/branch retinal vein occlusion is similar. The diagnostic tendency of using direct ophthalmoscopy and fundus photography to detect diabetic retinopathy is close. There is similar tendency of the using direct ophthalmoscopy and fundus photography in the diagnosis of hypertensive retinopathy as well. However, the diagnosis of concomitant conclusion is very weak. There is tendentious diagnostic efficiency of direct ophthalmoscopy in screening suspected glaucoma, epiretinal membranes and retinal abnormalities while tendentious diagnostic efficiency existed in high myopia and age-related macular degeneration detected by fundus photography.Conclusion: There is identical decisive diagnostic efficiency of direct ophthalmoscopy and fundus photography in detecting common eye diseases if the trainee can receive appropriate training.