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

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PURPOSE: To 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).

METHODS: Among 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.

RESULTS: CD 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).

CONCLUSIONS: FP is a promising, non-invasive substitute for FA in the diagnosis of CD. FAF was less reliable than FP to detect CD.

Original languageEnglish
JournalBritish Journal of Ophthalmology
Issue number3
Pages (from-to)378-82
Number of pages5
Publication statusPublished - Mar 2016

    Research areas

  • Adult, Aged, Aged, 80 and over, Bruch Membrane, Denmark, Eye Diseases, Hereditary, Female, Fundus Oculi, Humans, Male, Middle Aged, Observer Variation, Optical Imaging, Photography, Retina, Retinal Drusen, Rural Population, Young Adult, Journal Article

ID: 164155554