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ODs, retinal specialists yield similar diabetic retinopathy diagnoses
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DENVER – Ophthalmic retinal specialists and trained optometrists yield comparable diagnoses and classifications of diabetic retinopathy, according to a study presented here at the American Academy of Optometry meeting.
The study, presented by Albert Martinez, OD, was designed to determine the agreement among two independent optometrists and an ophthalmic retina specialist in diabetic retinopathy detection through fundus photograph evaluation.
The study involved 1,067 fundus photographs of 806 patients that were randomly selected from a database of 6,907 patients. This database belonged to a diabetic retinopathy screening program. Fundus photographs were evaluated regardless of age, sex or type of diabetes. Resolution sufficient to provide details of the fundus was the gauge of evaluability.
Each evaluator assessed and classified the photographs separately and independently. When a diagnosis of diabetic retinopathy was made, it was categorized as mild, moderate, severe, proliferative or laser-treated.
Kappa indices were used to assess agreement among the diagnoses. These indices compared optometrist 1 and optometrist 2 results vs. ophthalmic retina specialist results. Non-evaluable fundus photograph rates were 6.7%, 7.6% and 5% (optometrist 1, optometrist 2 and ophthalmic retinal specialist, respectively). In addition, good concordance was found for the different classification levels of diabetic retinopathy.
The study concluded that these kappa values suggested a high concordance for diabetic retinopathy diagnosis and classification between trained optometrists and an ophthalmic retina specialist.
"These results suggest that diabetic retinopathy screening can be performed with confidence by trained optometrists, who can then refer patients for ophthalmologic evaluation as needed," Dr. Martinez said.