Propective evaluation of digital non-tereo color fundu photography a a creening tool in age-related macular degeneration

Purpoe To evaluate mydriatic, non-tereo digital color fundu photograph a a creening tool for identifying and claifying exudative age-related macular degeneration (AMD). Deign Propective cae erie. Method Digital color fundu photograph were obtained from patient een in the AMD creening clinic over a 9-month period at the Ivey Eye Intitute in London, Ontario. Photograph for eligible patient were eparated by eye, cataloged, blinded, and randomly labeled before interpretation by an experienced vitreoretinal urgeon. Exact agreement, enitivity, pecificity, poitive predictive value, and negative predictive value of the fundu photograph in diagnoing, claifying, and managing cae of upected exudative AMD were then calculated againt gold tandard clinical examination and fluorecein angiography. Reult A total of 223 image were ued from 118 eligible patient. Exact agreement between photographic evaluation and gold tandard ranged from 89.2% (preence of pigment epithelial detachment (PED)) to 82.5% (evidence of retinal pigment epithelium geographic atrophy). enitivitie ranged from 89.2% (preence of choroidal neovacular membrane (CNVM)) to 40.0% (preence of PED). pecificitie ranged from 94.1% (preence of PED) to 86.8% (preence of retinal pigment epithelium geographic atrophy). Poitive predictive value ranged from 86.1% (preence of CNVM) to 40.0% (preence of PED). Negative predictive value ranged from 94.1% (preence of PED) to 88.9% (preence of CNVM). A a creening tool for high-rik dry change and active exudative change, overall enitivity pecificity, poitive predictive value, and negative predictive value were 82.1%, 79.1%, 70.4%, and 88.0%, repectively. Concluion Digital, non-tereo color fundu photograph are highly enitive and have high negative predictive value a a creening tool. Very few treatable leion are mied uing telemedicine in age-related macular degeneration.