creening for Diabetic Retinopathy by Ophthalmologit and Endocrinologit With Pupillary Dilation and a Nonmydriatic Digital Camera

Purpoe To ae the effect of pupillary dilation on image quality and certitude of creening diabetic retinopathy by trained endocrinologit uing a digital nonmydriatic camera. Deign Propective, comparative, obervational cae erie. Method One hundred fifty patient with diabete attending a hopital-baed photographic creening clinic had five-field (45 degree) digital retinal imaging and moaic contruction, firt through dark-adapted pupil, then after a ingle application of tropicamide 1%. The 600 et of image (150 patient, 300 eye, before and after dilation) were graded independently and in a blinded manner by two endocrinologit and two ophthalmologit, with the conenual opinion on dilated image of the latter erving a the gold tandard. The criteria of evaluation were aement of image quality and certitude of detecting and grading retinopathy. Reult Of 300 eye, pharmacological mydriai improved image quality, with an increae in the number of eye with five good image from even to 160 and good-quality moaic from 99 to 233. Dilation allowed better identification of maculopathy in the econd eye becaue there wa a decreae in ungradeable central image from 127 to 15 eye. Dilation increaed the number of eye having retinopathy detected with certainty from 153 to 252 and graded with certainty from 173 to 277. No advere effect were recorded. Concluion ingle application of tropicamide 1% ignificantly improve image quality and certitude of creening diabetic retinopathy with nonmydriatic camera by endocrinologit.