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BACKGROUND: Retinopathy of prematurity (ROP) affects premature low birth-weight infants with potentially blinding complications. Early diagnosis and treatment for indicated cases are essential to prevent unfavorable effects of the disease. OBJECTIVES: To determine the awareness and the level of knowledge of ROP among pediatricians in all regions of Saudi Arabia who worked at neonatal intensive care units. DESIGN AND SETTING: This was a cross-sectional study. This study was undertaken in the Kingdom of Saudi Arabia. MATERIALS AND METHODS: A semi-self-structured online questionnaire was designed to study the awareness and knowledge of ROP. The questionnaire contained items related to demographic data, participants' level of understanding and knowledge of ROP, and items related to hospital facilities, the availability of a trained ophthalmologist, and the source of knowledge. MAIN OUTCOME MEASURES: The awareness and knowledge of ROP among pediatricians of the Kingdom of Saudi Arabia. SAMPLE SIZE: The study included 145 pediatricians. RESULTS: Awareness of ROP was found in 138 participants (95.2%). Seven participants (4.8%) were not aware of ROP and were excluded from further analysis. Of the participants, 116 (84.0%), 127 (92.0%), and 130 (94.3%) had knowledge about the stages, treatment, and precautions of treatment of ROP, respectively. Of the participants, 77 (55.8%), 63 (45.7%), 113 (81.9%), and 56 (40.6%) gave the correct answer about the indications of fundus examination, exact time of the first fundus examination, place of fundus examination, and minimum number of screening fundus examination for ROP, respectively. CONCLUSIONS: The awareness and knowledge of ROP among pediatricians of Saudi Arabia is good, but knowledge about the indications and proper time of first referral to an ophthalmologist should be improved.
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Objective: To observe the consistency of a preliminary report of artificial intelligence (AI) in the clinical practice of fundus screening for diabetic retinopathy (DR) using non-mydriatic fundus photography. Methods: Patients who underwent DR screening in the Metabolic Disease Management Center (MMC) of our hospital were selected as research participants. The degree of coincidence of the AI preliminary report and the ophthalmic diagnosis was compared and analyzed, and the kappa value was calculated. Fundus fluorescein angiography (FFA) was performed in patients referred to the out-of-hospital ophthalmology department, and the consistency between fluorescein angiography and AI diagnosis was evaluated. Results: In total, 6146 patients (12,263 eyes) completed the non-mydriasis fundus examination. The positive DR screening rate was 24.3%. When considering moderate nonproliferative retinopathy as the cut-off point, the kappa coefficient was 0.75 (p < 0.001), the sensitivity was 0.973, and the precision was 0.642, which was shown in the precision-recall curve. Fifty-nine patients referred to receive FFA were compared with non-mydriatic AI diagnoses. The kappa coefficient was 0.53, and the coincidence rate was 66.9%. Conclusion: Non-mydriasis fundus examination combined with AI has a medium-high consistency with ophthalmologists in DR diagnosis, conducive to early DR screening. Combining diagnosis and treatment modes with the Internet can promote the development of telemedicine, alleviate the shortage of ophthalmology resources, and promote the process of blindness prevention and treatment projects.
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BACKGROUND: We aimed to determine the role of non-mydriatic fundus examination and artificial intelligence (AI) in screening diabetic retinopathy (DR) in patients with diabetes in the Metabolic Disease Management Center (MMC) in Tianjin, China. METHODS: Adult patients with type 2 diabetes mellitus who were first treated by MMC in Tianjin First Central Hospital and Tianjin 4th Center Hospital were divided into two groups according to the time that MMC was equipped with the non-mydriatic ophthalmoscope and AI system and could complete fundus examination independently (the former was the control group, the latter was the observation group). The observation indices were as follows: the incidence of DR, the fundus screening rate of the two groups, and fundus screening of diabetic patients with different course of disease. RESULTS: A total of 5039 patients were enrolled in this study. The incidence rate of DR was 18.6%, 29.8%, and 49.6% in patients with diabetes duration of ⩽1 year, 1-5 years, and >5 years, respectively. The screening rate of fundus in the observation group was significantly higher compared with the control group (81.3% versus 28.4%, χ 2 = 1430.918, p < 0.001). The DR screening rate of the observation group was also significantly higher compared with the control group in patients with diabetes duration of ⩽1 year (77.3% versus 20.6%; χ 2 = 797.534, p < 0.001), 1-5 years (82.5% versus 31.0%; χ 2 = 197.124, p < 0.001) and ⩾5 years (86.9% versus 37.1%; χ2 = 475.609, p < 0.001). CONCLUSIONS: In the case of limited medical resources, MMC can carry out one-stop examination, treatment, and management of DR through non-mydratic fundus examination and AI assistance, thus incorporating the DR screening process into the endocrine clinic, so as to facilitate early diagnosis.
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AIM: To compare the results of non-mydriatic ultra-wide field imaging system, mydriatic slit-lamp lens (Volk +90 D) and mydriatic Goldmann three-mirror contact lens examinations in screening fundus lesions among patients after cataract surgery. METHODS: Non-mydriatic images were obtained with an Optomap panoramic 200Tx (Optomap 200Tx) 3d after surgery and graded by a blinded ophthalmologist. A mydriatic slit-lamp lens examination was performed by another blinded retinal specialist on the same day. A third blinded retinal specialist examined patients two weeks after surgery using a Goldmann three-mirror contact lens. RESULTS: In total, 160 patients (184 eyes) were examined, and 66, 69, and 75 cases of retinal lesion(s) were identified using the Optomap 200Tx, slit-lamp lens, and Goldmann three-mirror contact lens, respectively. In 13 cases, fundus changes were sight-threatening. The results obtained by Optomap 200Tx examination and by mydriatic slit-lamp lens examination have good consistency (P=0.375, Kappa=0.942). The mydriatic Goldmann three-mirror lens examination revealed more fundus lesions but are consistent with Optomap 200Tx (P=0.004, Kappa=0.897) and mydriatic slit-lamp lens examination (P=0.031, Kappa=0.932). CONCLUSION: Early post-operative fundus screening in cataract patients is extremely important and necessary to prevent further vision loss. Wide-field imaging is a feasible and convenient tool for fundus examination that can be used as a primary screening method among patients after cataract surgery.