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Comparison of 50° handheld fundus camera versus ultra-widefield table-top fundus camera for diabetic retinopathy detection and grading

Eye volume 37, pages 2994–2999 (2023)Cite this article

Subjects

Abstract

Objectives

To compare the performance of a handheld fundus camera with standard 50° visual field to ultra-widefield (UWF) table-top fundus camera in diabetic retinopathy (DR) detection and grading.

Methods

Patients affected by diabetes mellitus and referred to our diabetic retinopathy clinic were enroled and underwent fundus photography in mydriasis. All photos were taken using the ultra-widefield table-top fundus camera Zeiss Clarus™ 500 (four fields per eye) and the Optomed Aurora® handheld fundus camera (3 fields per eye). The following parameters were analysed: the gradability of the images, the grade of DR, and diabetic maculopathy (DM), the presence of hypertensive retinopathy (HR) and the presence of other ocular diseases.

Results

We enroled 759 eyes of 384 diabetic patients and analysed 5313 fundus photos. The handheld fundus camera obtained a sensitivity of 84.2% and specificity of 95.4% for referable cases. Moreover, it obtained, compared to UWF, an almost perfect agreement with linear weighting for DR, DM and HR (k = 0.877, k = 0.854, and k = 0.961, respectively). The lowest sensitivity was achieved for proliferative DR (58.7% sensitivity, 100% specificity).

Conclusions

Optomed Aurora® handheld fundus camera imaging showed a strong agreement compared to UWF in grading DR, considering all DR and DM grades, in mydriasis. However, the use of UWF imaging increases the detection of referable eyes.

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Data availability

All data generated or analysed during this study are included in this published article [and its supplementary information files].

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Acknowledgements

The research contribution of the Fondazione Bietti in this paper was supported by the Ministry of Health and Fondazione Roma. The authors thank Fabiano Cavarzeran, Ophthalmology Clinic, Department of Ophthalmology, University of Padova, Padova, Italy, for his support in the statistical analysis.

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Authors and Affiliations

  1. Department of Ophthalmology, University of Padova, Padova, Italy

    Edoardo Midena, Luca Zennaro, Cristian Lapo, Tommaso Torresin & Luisa Frizziero

  2. IRCCS - Fondazione Bietti, Rome, Italy

    Edoardo Midena & Giulia Midena

Authors
  1. Edoardo Midena
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  2. Luca Zennaro
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  3. Cristian Lapo
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  4. Tommaso Torresin
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  5. Giulia Midena
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  6. Luisa Frizziero
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Contributions

EM and LF were responsible for conceptualisation, methodology and validation; LZ and CL were responsible for data curation and formal analysis; GM and TT were responsible for the investigation and data curation; LZ and LF were responsible for the investigation and original draft preparation. All Authors were responsible for review and editing.

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Correspondence to Edoardo Midena.

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Midena, E., Zennaro, L., Lapo, C. et al. Comparison of 50° handheld fundus camera versus ultra-widefield table-top fundus camera for diabetic retinopathy detection and grading. Eye 37, 2994–2999 (2023). https://doi.org/10.1038/s41433-023-02458-3

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