Limitations of non-mydriatic retinography as a screening tool of diabetic retinopathy: a scoping review
DOI:
https://doi.org/10.25758/set.2277Keywords:
Diabetic retinopathy, Screening, Non-mydriatic retinography, Retinal imaging, LimitationsAbstract
Introduction – Diabetic retinopathy is one of the main microvascular complications of diabetes and it is the leading cause of preventable blindness in working-age adults in developed countries. With a long asymptomatic period, early diagnosis allows avoiding aggressive, repeated, and expensive therapies. The annual examination for early detection of diabetic retinopathy, using non-mydriatic retinography, is accepted as a gold standard method, however, this method has some weaknesses. Aim of the study – To describe the existing scientific evidence of the limitations of the isolated use of non-mydriatic retinography as a screening
tool of diabetic retinopathy. Methods – Descriptive study of scoping review based on Joanna Briggs Institute methodology. PubMed and Web of Science databases were used to search for scientific articles. The following inclusion criteria were used: articles with a population of diabetic subjects who underwent screening for diabetic retinopathy through non-mydriatic retinography; articles written in English or Portuguese and published between January 2000 and June 2020. Results – After the data screening, six references were included based on inclusion criteria. The rate of unclassifiable images is the major limitation of this method. A positive correlation was found between increasing age and non-gradable images, most of the time due to opacities of the
optical media, smaller pupil diameter, and presence of other pathologies. Several studies have also reported that retinography has limited ability to detect diabetic macular edema. Conclusions – New technologies and new methods of retinal imaging can potentially be adopted by screening programs, in the future, in order to provide solutions for the most effective and efficient
detection of diabetic retinopathy and diabetic macular edema, reducing the percentage of patients with unclassifiable images.
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