An evaluation of fundus photography and fundus autofluorescence in the diagnosis of cuticular drusen

• Published in: British journal of ophthalmology Vol. 100; no. 3; pp. 378 - 382
• Main Authors: Høeg, Tracy B, Moldow, Birgitte, Klein, Ronald, La Cour, Morten, Klemp, Kristian, Erngaard, Ditte, Ellervik, Christina, Buch, Helena
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group LTD 01.03.2016
• Subjects: Adult; Age; Aged; Aged, 80 and over; Bruch Membrane - pathology; Denmark; Eye Diseases, Hereditary - classification; Eye Diseases, Hereditary - diagnosis; Female; Fundus Oculi; Humans; Macular degeneration; Male; Medical research; Mens health; Middle Aged; Observer Variation; Optical Imaging; Participation; Photography; Retina - pathology; Retinal Drusen - classification; Retinal Drusen - diagnosis; Rural Population; Studies; Womens health; Young Adult; Denmark; Retina; Imaging; Diagnostic tests/Investigation
• ISSN: 0007-1161; 1468-2079
• DOI: 10.1136/bjophthalmol-2015-307197

PurposeTo examine non-mydriatic fundus photography (FP) and fundus autofluorescence (FAF) as alternative non-invasive imaging modalities to fluorescein angiography (FA) in the detection of cuticular drusen (CD).MethodsAmong 2953 adults from the Danish Rural Eye Study (DRES) with gradable FP, three study groups were selected: (1) All those with suspected CD without age-related macular degeneration (AMD) on FP, (2) all those with suspected CD with AMD on FP and (3) a randomly selected group with early AMD. Groups 1, 2 and 3 underwent FA and FAF and group 4 underwent FAF only as part of DRES CD substudy. Main outcome measures included percentage of correct positive and correct negative diagnoses, Cohen's κ and prevalence-adjusted and bias-adjusted κ (PABAK) coefficients of test and grader reliability.ResultsCD was correctly identified on FP 88.9% of the time and correctly identified as not being present 83.3% of the time. CD was correctly identified on FAF 62.0% of the time and correctly identified as not being present 100.0% of the time. Compared with FA, FP has a PABAK of 0.75 (0.60 to 1.5) and FAF a PABAK of 0.44 (0.23 to 0.95).ConclusionsFP is a promising, non-invasive substitute for FA in the diagnosis of CD. FAF was less reliable than FP to detect CD.