Premium
Concordance between ophtalmologists and paramedical professionals in screening for retinal abnormalities with ultrawide field imaging
Author(s) -
Durbant E.,
Vardi K.,
Bordet J.,
Barbe C.,
Garcia T.,
Angioi K.,
Arndt C.
Publication year - 2015
Publication title -
acta ophthalmologica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.534
H-Index - 87
eISSN - 1755-3768
pISSN - 1755-375X
DOI - 10.1111/j.1755-3768.2015.0363
Subject(s) - medicine , concordance , mydriasis , retinal , ophthalmology , cohen's kappa , optometry , outpatient clinic , visual field , computer science , machine learning
Purpose The decreasing number of ophthalmologists leads to evaluate preliminary screening procedures performed by paramedical professionnals. The ultrawide field retinography is a recent technique allowing to obtain, simply and reproducibly, central and peripheral retinal images with or without mydriasis.The main objective of this study was to evaluate the diagnostic agreement between the reading of the ultra wide field images by a paramedical professional compared to a doctor. Methods A prospective diagnostic two‐center study was performed in the ophthalmological departments of two University Hospitals (Reims and Nancy) including all patients eligible in an outpatient clinic. For each patient, an ultra wide field retinography was taken with an Optomap (Optos) and an image analysis was performed by both a paramedical professional and an ophthalmologist. The agreement (kappa coefficient) between both image readings was evaluated. Results 901 patients were included from July 2011 to November 2014. A good agreement was found between paramedical professionals and ophthalmologists for the global analysis (normal or abnormal image) ( k = 0.62 [0.59 to 0.66]).This good concordance was also found for retinal lesions, including the macula (k = 0.70 [0.66 to 0.73]) and particularly for the analysis of red lesions such as hemorrhages, dilated veins and retinal detachment. However, the agreement was poor for optic disc analysis (k = 0.38 [0.32 to 0.44]). Conclusions In screening procedures, paramedical professionals were able to identify retinal abnormalities on ultra wide field image in a significant number of cases. However, the correct identification of optic disc abnormalities was poor.