Background: Photographic screening for neovascular age- related macular degeneration (AMD) is not commonly employed because the preval ence of treatable disease is low and fluorescein angiography is considered neces s...Background: Photographic screening for neovascular age- related macular degeneration (AMD) is not commonly employed because the preval ence of treatable disease is low and fluorescein angiography is considered neces sary for the diagnosis of this form of AMD. However, there may be a role for col our retinal imaging in assisting with the diagnosis and triage of subjects with neovascular AMD. The purpose of this study was to evaluate the utility of colour fundus photographs for identifying subjects with potentially treatable neovascu lar AMD. Methods: A total of 74 stereo pairs of Kodachrome colour slides of subj ects with AMD were evaluated (i) nonstereoscopically, (ii) stereoscopically, and (iii) stereoscopically with visual acuity and visual symptom data. Two retina s pecialists read the images to identify active exudative lesions. Results: The ka ppa statistic comparing the retinal specialists diagnosis of treatable neovascul ar AMD from color slides was excellent. The sensitivity and specificity of nonst ereo images for the appropriate categorization of lesions was 0.95 and 0.90 resp ectively. The evaluation of stereo pairs was more sensitive, but less specific, 0.98, 0.83, as was the evaluation of stereo-pairs with clinical histories and v isual acuities, 1.00, 0.77. Conclusions: The evaluation of colour images for sub jects with suspected exudative macular degeneration can be diagnostic for neovas cular AMD and may expedite the appropriate referral of patients for more timely angiography and treatment. Incorporating more clinical information for the image evaluators (i) stereo image pairs and/or (ii) presenting symptomatology and vis ual acuity data) led to a decrease in the false-negative rate, but also decreas ed the screening specificity.展开更多
文摘Background: Photographic screening for neovascular age- related macular degeneration (AMD) is not commonly employed because the preval ence of treatable disease is low and fluorescein angiography is considered neces sary for the diagnosis of this form of AMD. However, there may be a role for col our retinal imaging in assisting with the diagnosis and triage of subjects with neovascular AMD. The purpose of this study was to evaluate the utility of colour fundus photographs for identifying subjects with potentially treatable neovascu lar AMD. Methods: A total of 74 stereo pairs of Kodachrome colour slides of subj ects with AMD were evaluated (i) nonstereoscopically, (ii) stereoscopically, and (iii) stereoscopically with visual acuity and visual symptom data. Two retina s pecialists read the images to identify active exudative lesions. Results: The ka ppa statistic comparing the retinal specialists diagnosis of treatable neovascul ar AMD from color slides was excellent. The sensitivity and specificity of nonst ereo images for the appropriate categorization of lesions was 0.95 and 0.90 resp ectively. The evaluation of stereo pairs was more sensitive, but less specific, 0.98, 0.83, as was the evaluation of stereo-pairs with clinical histories and v isual acuities, 1.00, 0.77. Conclusions: The evaluation of colour images for sub jects with suspected exudative macular degeneration can be diagnostic for neovas cular AMD and may expedite the appropriate referral of patients for more timely angiography and treatment. Incorporating more clinical information for the image evaluators (i) stereo image pairs and/or (ii) presenting symptomatology and vis ual acuity data) led to a decrease in the false-negative rate, but also decreas ed the screening specificity.
