Sensitivity and specificity of fundus photograph in detecting diabetic macular edema

XIONG Yongqun; HE Yushen; XIE Peiwen; ZHENG Yi; LIN Jianwei; LI Yuancun; ZHANG Guihua

doi:10.7619/jcmp.20232028

Journal of Clinical Medicine in Practice > 2023 > 27(18): 44-48. > DOI: 10.7619/jcmp.20232028

XIONG Yongqun, HE Yushen, XIE Peiwen, ZHENG Yi, LIN Jianwei, LI Yuancun, ZHANG Guihua. Sensitivity and specificity of fundus photograph in detecting diabetic macular edema[J]. Journal of Clinical Medicine in Practice, 2023, 27(18): 44-48. DOI: 10.7619/jcmp.20232028

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Sensitivity and specificity of fundus photograph in detecting diabetic macular edema

1.
Joint Shantou International Eye Center of Shantou University and The Chinese University of Hongkong, Shantou, Guangdong, 515041
2.
Ophthalmic Center, Foshan Second People's Hospital of Guangdong Province, Foshan, Guangdong, 528000

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Received Date: June 25, 2023
Revised Date: August 14, 2023
Available Online: October 08, 2023

Graphical Abstract

Abstract

Abstract

Objective
To evaluate the sensitivity and specificity of fundus photograph in detecting diabetic macular edema (DME) in screening for diabetic retinopathy (DR).
Methods
Data of 1 438 patients with DR were collected. All patients received uncorrected visual acuity, best corrected visual acuity, color fundus photography, and spectral domain optical coherence tomography (SD-OCT). Using SD-OCT as the gold standard for the diagnosis of DME, the sensitivity, specificity and area under receiver operator characteristic (ROC) curve (AUC) of fundus color photography were evaluated.
Results
A total of 1 438 patients with an average age of (57.7±11.0) years were enrolled in this study, with a total of 2 326 eyes. There were 1 412 eyes of background DR (group R1), 710 eyes of pre-proliferative DR (group R2) and 204 eyes of proliferative DR (group R3). The sensitivity of DME detected by fundus photograph was 78.8% (95%CI, 76.1% to 81.2%), the specificity was 56.6% (95%CI, 54.0% to 59.3%), and the AUC was 0.677 (95%CI, 0.659 to 0.696). In group R1, the sensitivity, specificity and AUC of DME detected by fundus photograph were 68.6% (95%CI, 64.2% to 72.7%), 58.8% (95%CI, 69.4% to 75.4%) and 0.637 (95%CI, 0.611 to 0.664), respectively; in the R2 group, the sensitivity, specificity and AUC were 86.3% (95%CI, 82.3% to 89.4%), 52.0% (95%CI, 46.8% to 57.2%) and 0.691 (95%CI, 0.660 to 0.723), respectively; in R3 group, the sensitivity, specificity and AUC were 89.3% (95%CI, 83.8% to 93.2%), 42.9% (95%CI, 28.0% to 59.1%) and 0.661 (95%CI, 0.575 to 0.747), respectively.
Conclusion
The sensitivity of fundus photograph to detect DME in DR screening is high, but the specificity is low, and the use of fundus color imaging alone to screen DME will lead to transfer treatments of nearly half of the patients.
- fundus photograph,
- diabetes,
- macular edema,
- sensitivity,
- specificity,
- spectral domain optical coherence tomography

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References (14)

References

[1]	TEO Z L, THAM Y C, YU M, et al. Global prevalence of diabetic retinopathy and projection of burden through 2045: systematic review and meta-analysis[J]. Ophthalmology, 2021, 128(11): 1580-1591. doi: 10.1016/j.ophtha.2021.04.027
[2]	WONG T Y, CHEUNG C M G, LARSEN M, et al. Diabetic retinopathy[J]. Nat Rev Dis Primers, 2016, 2: 16012. doi: 10.1038/nrdp.2016.12
[3]	ZHANG G H, CHEN H Y, CHEN W Q, et al. Prevalence and risk factors for diabetic retinopathy in China: a multi-hospital-based cross-sectional study[J]. Br J Ophthalmol, 2017, 101(12): 1591-1595. doi: 10.1136/bjophthalmol-2017-310316
[4]	WONG R L, TSANG C W, WONG D S, et al. Are we making good use of our public resources The false-positive rate of screening by fundus photography for diabetic macular oedema[J]. Xianggang Yi Xue Za Zhi, 2017, 23(4): 356-364.
[5]	BASKIN D E. Optical coherence tomography in diabetic macular edema[J]. Curr Opin Ophthalmol, 2010, 21(3): 172-177. doi: 10.1097/ICU.0b013e32833866ae
[6]	PETO T, TADROS C. Screening for diabetic retinopathy and diabetic macular edema in the United Kingdom[J]. Curr Diab Rep, 2012, 12(4): 338-345. doi: 10.1007/s11892-012-0285-4
[7]	PRESCOTT G, SHARP P, GOATMAN K, et al. Improving the cost-effectiveness of photographic screening for diabetic macular oedema: a prospective, multi-centre, UK study[J]. Br J Ophthalmol, 2014, 98(8): 1042-1049. doi: 10.1136/bjophthalmol-2013-304338
[8]	何沁, 韩伟. 抗血管内皮生长因子治疗糖尿病黄斑水肿研究进展[J]. 中国实用眼科杂志, 2017, 35(2): 97-101.
[9]	DATE R C, SHEN K L, SHAH B M, et al. Accuracy of detection and grading of diabetic retinopathy and diabetic macular edema using teleretinal screening[J]. Ophthalmol Retina, 2019, 3(4): 343-349. doi: 10.1016/j.oret.2018.12.003
[10]	D'ALOISIO R, GIGLIO R, NICOLA M D, et al. Diagnostic accuracy of digital retinal fundus image analysis in detecting diabetic maculopathy in type 2 diabetes mellitus[J]. Ophthalmic Res, 2019, 61(2): 100-106. doi: 10.1159/000494499
[11]	VIRGILI G, MENCHINI F, DIMASTROGIOVANNI A F, et al. Optical coherence tomography versus stereoscopic fundus photography or biomicroscopy for diagnosing diabetic macular edema: a systematic review[J]. Invest Ophthalmol Vis Sci, 2007, 48(11): 4963-4973. doi: 10.1167/iovs.06-1472
[12]	BALTATESCU A, STRIGLIA E, TRENTO M, et al. Detection of perimacular red dots and blots when screening for diabetic retinopathy: refer or not refer[J]. Diabetes & Vasc Dis Res, 2018, 15: 356-359.
[13]	KIM B Y, SMITH S D, KAISER P K. Optical coherence tomographic patterns of diabetic macular edema[J]. Am J Ophthalmol, 2006, 142(3): 405-412, e1. doi: 10.1016/j.ajo.2006.04.023
[14]	SHRESTHA A, MAHARJAN N, SHRESTHA A, et al. Optical coherence tomographic assessment of macular thickness and morphological patterns in diabetic macular edema: prognosis after modified grid photocoagulation[J]. Nepal J Ophthalmol, 2012, 4(1): 128-133.

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Sensitivity and specificity of fundus photograph in detecting diabetic macular edema