Telemedical diabetic retinopathy screening in Hungary: a pilot programme

Dorottya Szabó, Orsolya Fiedler, A. Somogyi, G. M. Somfai, Zsolt Bíró, Veronika Ölvedy, Zsófia Hargitai, J. Németh

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Our aim was to introduce the Hungarian pilot telemedical screening program for diabetic retinopathy (DRP) and also to evaluate the efficacy of non-mydriatic fundus photographs. A total of 502 eyes of 251 diabetic patients were photographed with a non-mydriatic digital fundus camera in a tertiary diabetology care center. These three 45°-field images were transmitted to the reading center via Internet, where they were graded by two independent ophthalmologists. After non-mydriatic photography (NM method), 28 patients were also examined in mydriasis by an ophthalmologist (O method) and were also photographed in mydriasis (M method). For the comparison of the three methods the kappa statistic was used. With non-mydriatic imaging of 502 eyes no retinopathy was found in 74.5%, DRP was detected in 15.5%, while 10.1% of the photos were ungradable. The rates of DRP severity levels were: 13.55% mild/moderate non-proliferative, 0.59% severe and 1.39% proliferative DRP. Comparing the results of the gradable non-mydriatic photos by the two independent graders, perfect intergrader agreement was found (k = 1.00). The measure of intermethod agreement between NM and M method was also perfect, with a kappa value of 1.00 (grader A and grader B). Based on the results of the O method, there were no misdiagnosed cases nor with the NM-, neither with the M method. Non-mydriatic cameras could be ideal tools of an extended countrywide retinopathy screening program which may serve to reduce the high prevalence of diabetes-related blindness in Hungary.

Original languageEnglish
Pages (from-to)167-173
Number of pages7
JournalJournal of Telemedicine and Telecare
Volume21
Issue number3
DOIs
Publication statusPublished - Apr 1 2015

Fingerprint

Hungary
Diabetic Retinopathy
Mydriasis
Photography
Blindness
Diagnostic Errors
Tertiary Care Centers
Internet
Reading

ASJC Scopus subject areas

  • Health Informatics

Cite this

Telemedical diabetic retinopathy screening in Hungary : a pilot programme. / Szabó, Dorottya; Fiedler, Orsolya; Somogyi, A.; Somfai, G. M.; Bíró, Zsolt; Ölvedy, Veronika; Hargitai, Zsófia; Németh, J.

In: Journal of Telemedicine and Telecare, Vol. 21, No. 3, 01.04.2015, p. 167-173.

Research output: Contribution to journalArticle

Szabó, Dorottya ; Fiedler, Orsolya ; Somogyi, A. ; Somfai, G. M. ; Bíró, Zsolt ; Ölvedy, Veronika ; Hargitai, Zsófia ; Németh, J. / Telemedical diabetic retinopathy screening in Hungary : a pilot programme. In: Journal of Telemedicine and Telecare. 2015 ; Vol. 21, No. 3. pp. 167-173.
@article{bf18d163150e46ffa4874156427da423,
title = "Telemedical diabetic retinopathy screening in Hungary: a pilot programme",
abstract = "Our aim was to introduce the Hungarian pilot telemedical screening program for diabetic retinopathy (DRP) and also to evaluate the efficacy of non-mydriatic fundus photographs. A total of 502 eyes of 251 diabetic patients were photographed with a non-mydriatic digital fundus camera in a tertiary diabetology care center. These three 45°-field images were transmitted to the reading center via Internet, where they were graded by two independent ophthalmologists. After non-mydriatic photography (NM method), 28 patients were also examined in mydriasis by an ophthalmologist (O method) and were also photographed in mydriasis (M method). For the comparison of the three methods the kappa statistic was used. With non-mydriatic imaging of 502 eyes no retinopathy was found in 74.5{\%}, DRP was detected in 15.5{\%}, while 10.1{\%} of the photos were ungradable. The rates of DRP severity levels were: 13.55{\%} mild/moderate non-proliferative, 0.59{\%} severe and 1.39{\%} proliferative DRP. Comparing the results of the gradable non-mydriatic photos by the two independent graders, perfect intergrader agreement was found (k = 1.00). The measure of intermethod agreement between NM and M method was also perfect, with a kappa value of 1.00 (grader A and grader B). Based on the results of the O method, there were no misdiagnosed cases nor with the NM-, neither with the M method. Non-mydriatic cameras could be ideal tools of an extended countrywide retinopathy screening program which may serve to reduce the high prevalence of diabetes-related blindness in Hungary.",
author = "Dorottya Szab{\'o} and Orsolya Fiedler and A. Somogyi and Somfai, {G. M.} and Zsolt B{\'i}r{\'o} and Veronika {\"O}lvedy and Zs{\'o}fia Hargitai and J. N{\'e}meth",
year = "2015",
month = "4",
day = "1",
doi = "10.1177/1357633X15572712",
language = "English",
volume = "21",
pages = "167--173",
journal = "Journal of Telemedicine and Telecare",
issn = "1357-633X",
publisher = "SAGE Publications Ltd",
number = "3",

}

TY - JOUR

T1 - Telemedical diabetic retinopathy screening in Hungary

T2 - a pilot programme

AU - Szabó, Dorottya

AU - Fiedler, Orsolya

AU - Somogyi, A.

AU - Somfai, G. M.

AU - Bíró, Zsolt

AU - Ölvedy, Veronika

AU - Hargitai, Zsófia

AU - Németh, J.

PY - 2015/4/1

Y1 - 2015/4/1

N2 - Our aim was to introduce the Hungarian pilot telemedical screening program for diabetic retinopathy (DRP) and also to evaluate the efficacy of non-mydriatic fundus photographs. A total of 502 eyes of 251 diabetic patients were photographed with a non-mydriatic digital fundus camera in a tertiary diabetology care center. These three 45°-field images were transmitted to the reading center via Internet, where they were graded by two independent ophthalmologists. After non-mydriatic photography (NM method), 28 patients were also examined in mydriasis by an ophthalmologist (O method) and were also photographed in mydriasis (M method). For the comparison of the three methods the kappa statistic was used. With non-mydriatic imaging of 502 eyes no retinopathy was found in 74.5%, DRP was detected in 15.5%, while 10.1% of the photos were ungradable. The rates of DRP severity levels were: 13.55% mild/moderate non-proliferative, 0.59% severe and 1.39% proliferative DRP. Comparing the results of the gradable non-mydriatic photos by the two independent graders, perfect intergrader agreement was found (k = 1.00). The measure of intermethod agreement between NM and M method was also perfect, with a kappa value of 1.00 (grader A and grader B). Based on the results of the O method, there were no misdiagnosed cases nor with the NM-, neither with the M method. Non-mydriatic cameras could be ideal tools of an extended countrywide retinopathy screening program which may serve to reduce the high prevalence of diabetes-related blindness in Hungary.

AB - Our aim was to introduce the Hungarian pilot telemedical screening program for diabetic retinopathy (DRP) and also to evaluate the efficacy of non-mydriatic fundus photographs. A total of 502 eyes of 251 diabetic patients were photographed with a non-mydriatic digital fundus camera in a tertiary diabetology care center. These three 45°-field images were transmitted to the reading center via Internet, where they were graded by two independent ophthalmologists. After non-mydriatic photography (NM method), 28 patients were also examined in mydriasis by an ophthalmologist (O method) and were also photographed in mydriasis (M method). For the comparison of the three methods the kappa statistic was used. With non-mydriatic imaging of 502 eyes no retinopathy was found in 74.5%, DRP was detected in 15.5%, while 10.1% of the photos were ungradable. The rates of DRP severity levels were: 13.55% mild/moderate non-proliferative, 0.59% severe and 1.39% proliferative DRP. Comparing the results of the gradable non-mydriatic photos by the two independent graders, perfect intergrader agreement was found (k = 1.00). The measure of intermethod agreement between NM and M method was also perfect, with a kappa value of 1.00 (grader A and grader B). Based on the results of the O method, there were no misdiagnosed cases nor with the NM-, neither with the M method. Non-mydriatic cameras could be ideal tools of an extended countrywide retinopathy screening program which may serve to reduce the high prevalence of diabetes-related blindness in Hungary.

UR - http://www.scopus.com/inward/record.url?scp=84939643844&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84939643844&partnerID=8YFLogxK

U2 - 10.1177/1357633X15572712

DO - 10.1177/1357633X15572712

M3 - Article

C2 - 25712110

AN - SCOPUS:84939643844

VL - 21

SP - 167

EP - 173

JO - Journal of Telemedicine and Telecare

JF - Journal of Telemedicine and Telecare

SN - 1357-633X

IS - 3

ER -