Previous studies have found that nonmydriatic digital retinal imaging alone exhibits performance comparable with dilated fundus examination and with dilated fundus photography for the detection of diabetic retinopathy. Retinal imaging (fundus photography) has been used extensively in photodocumentation for clinical purposes, as well as in research, telemedicine, and patient education during routine eye care. 1 – 4 The use of nonmydriatic digital retinal imaging in the assessment and management of ocular disease is becoming increasingly widespread. Timely detection and treatment of ocular disease can lower the risk of vision loss and reduce health care costs, particularly for those with diabetes and those at risk for age-related macular degeneration and glaucoma. When the methods disagreed, the results indicated a statistically significant advantage for the image-assisted examination in detecting suspicious cupping ( P = 0.04), drusen in the posterior pole/macula and mid-to-peripheral retina ( P = 0.004, P < 0.001), retinal pigment epithelial changes in the posterior pole/macula ( P = 0.04), nevi in the posterior pole/macula and mid-to-peripheral retina ( P = 0.01, P = 0.007), peripheral retinal degeneration ( P < 0.001), hemorrhage in the mid-to-peripheral retina ( P = 0.01), and vitreous lesions ( P < 0.001). Agreement was poor for hemorrhage in the mid-to-peripheral retina (kappa 0.33), and nevi in the mid-to-peripheral retina (0.34). Agreement between image-assisted and traditional fundus examination varied by lesion type and was excellent for staphyloma (kappa 0.76), fair for suspicious cupping (kappa 0.66), drusen in the posterior pole/macula and mid-to-peripheral retina (0.45, 0.41), retinal pigment epithelial changes in the posterior pole/macula (0.54), peripheral retinal degeneration (0.50), cobblestone (0.69), vitreoretinal interface abnormalities (0.40), and vitreous lesions (0.53). This is a 2021 ARVO Annual Meeting abstract.In total, 170 subjects (339 eyes) were recruited. Analysis of the retinal images will determine their correlations with other medical tests, including cognitive testing, nutrition, and biologic biomarkers. Future work will assess the influences of socioeconomic status and race on eye disease. Moderate visual impairment was seen in 51 (11.9%) participants who had VA between 20/50 and 20/200 in the better seeing eye.įundus photography in this cohort identified potential ocular pathology with recommendation for follow-up with an ophthalmologist in about half of participants. Of the 427 participants with VA data, the majority (375 87.8%) had VA ≥20/40 in at least one eye. Cup-to-disc ratios of the optic nerves were graded as ≥0.5 in 434/1761 eyes (24.6%). Roughly half of eyes (1018) were found to have abnormal findings, most commonly glaucoma/glaucoma suspect (295 eyes ), hypertensive retinopathy (156 eyes ), macular degeneration (100 eyes ), and retinal hemorrhage (39 eyes, ). The image quality was gradable in 1646/1930 (85.3%) of photos. The participants were 60.8% women (587) and 63.4% African American (612). Data were analyzed using R statistical software.Ī total of 965 participants (mean age: 59.3☘.8 years) underwent fundus photography. Presenting visual acuities (VA) were collected beginning in 2019. The images were graded by ophthalmologists who were masked to the other clinical data. Participants in wave 5 also underwent color fundus photography (TopCon TRC-NW400 non-mydriatic camera) at their study visit. Detailed testing is performed to assess nutrition, cognition, and biologic biomarkers. In the HANDLS study, mobile research vehicles are used to evaluate all participants every 4 years. An ophthalmic component was added in 2017 to evaluate the prevalence and characteristics of eye disease in this population. Participants are urban African American and white adults recruited from 13 neighborhoods in Baltimore City. The Healthy Aging in Neighborhoods of Diversity across the Life Span (HANDLS) study is an ongoing prospective cohort study initiated in 2004 to evaluate the influences of socioeconomic status and race on the incidence of age-related diseases in the United States.
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