@article {603866,
	title = {Accuracy of a technology-assisted eye exam in evaluation of referable diabetic retinopathy and concomitant ocular diseases.},
	journal = {Br J Ophthalmol},
	volume = {99},
	number = {12},
	year = {2015},
	month = {2015 Dec},
	pages = {1622-7},
	abstract = {BACKGROUND/AIMS: Digital retinal imaging using store-and-forward technology is used to screen for diabetic retinopathy (DR). Its usefulness in detecting non-diabetic eye diseases is uncertain. We determined the level of agreement between teleretinal imaging supplemented with visual acuity and intraocular pressure (IOP) measurements (ie, technology-assisted eye (TAE) exam) and a comprehensive eye exam in evaluation for DR and non-diabetic ocular conditions. METHODS: We conducted a prospective, observational study with two parallel evaluations. Patients with diabetes (n=317) had a TAE exam and a comprehensive eye exam on the same day. A subset of participants with normal baseline exams (n=72) had follow-up exams 1 year later. We measured the level of agreement for referable ocular findings. RESULTS: Agreement for referable ocular findings was moderate (n=389, agreement: 77\%; κ: 0.55), due in part to ungradable exams (22\%). However, about half of the ungradable exams had findings that warranted referral. There was substantial agreement for follow-up exams (n=72, agreement: 93\%; κ: 0.63). Among all gradable exams (n=303), the TAE exam had 86\% sensitivity and 84\% specificity for referable ocular findings, with high agreement (>=94\%) for DR and other major ocular diagnoses. CONCLUSIONS: There was moderate-to-substantial agreement between a TAE exam and a comprehensive eye exam for referable ocular findings in patients with diabetes. Ungradable exams were a frequent marker of ocular pathology. Teleretinal imaging may be a useful evaluation for both diabetic and non-diabetic ocular conditions.},
	issn = {1468-2079},
	doi = {10.1136/bjophthalmol-2014-306536},
	author = {Conlin, Paul R and Asefzadeh, Baharak and Pasquale, Louis R and Selvin, Gerald and Lamkin, Rebecca and Cavallerano, Anthony A}
}
