Direct Ophthalmoscopy versus Fundus Photography in Children with Type 1 Diabetes Mellitus

Abstract

Background: Clinical fundus examination in addition to fundus photography of Type 1 diabetes mellitus (T1DM) children patients to detect complications like diabetic retinopathy (DR). This study aimed to evaluate direct ophthalmoscopy accuracy compared to fundus photography in diagnosing diabetic retinopathy in children with T1DM at Zagazig University Hospital.Methods: We carried out this cross-sectional study on 42 children diagnosed with T1DM for over five years who attended the Pediatrics Outpatient Clinic at Zagazig University Hospital. Routine laboratory investigations, such as complete blood count and blood glucose level, HbA1c, and albumin/creatinine ratio in urine, were done on all patients, in addition to direct ophthalmoscopy and fundus photography, for diagnosis of diabetic retinopathy.Results: Direct ophthalmoscopy had a sensitivity of 25% and a specificity of 100%. On the other hand, fundus photography demonstrated a sensitivity of 80.69% and a specificity of 92.23%. Regarding PPV and NPV, direct ophthalmoscopy showed a PPV of 100% and an NPV of 75%. Conclusion: Direct ophthalmoscopy's sensitivity and specificity for detecting the presence and severity of DR were found to be lower than the recommended levels for a DR screening test.