Table 1. Characteristics of studies included in the meta-analysis.
Sens: sensitivity; Spec: specificity; AUC, area under the curve; dOR, diagnostic odds ratio; FPG, fasting plasma glucose; 2h-PG, 2 hours plasma glucose.
| Diabetes retinopathy diagnosis | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Reference | Country | Study/Year data collection | Ophthalmic examination test | Age | n | Prevalence of retinopathy | Diagnostic test | Cut-off point | Sens (%) | Spec (%) | AUC | dOR |
| Sabanayagam et al. 201520 | India | SINDI/2007–09 SiMES/2004–06; SCES/2009–11 |
two 45° retinal images | 56.4 (10.3) 57.0 (11.5) 54.6 (11.7) |
3,740 3,596 5,834 |
4.4 3.8 1.6 |
HbA1ca HbA1cb HbA1cc |
6.5 6.5 6.5 |
86.0 85.3 75.8 |
71.9 76.3 89.7 |
0.851 0.853 0.861 |
15.34 18.63 27.28 |
| Mukai et al. 201421 | Japan | HISAYAMA study/2007–08 | 45° fundus photographs | 49–70 | 2,681 | 1.9 | HbA1c FPG 2h-PG |
6.1 6.5 11.5 |
86.5 82.7 90.4 |
88.8 86.6 89.3 |
0.919 0.908 0.947 |
50.80 30.89 78.60 |
| Park et al. 201422 | Korean | 5th KNHANES/2011 | 45° nonmydriatic digital retinal image | >19 (44.3±0.4) | 5,212 | 1.6 | HbA1c FPG |
6.2 6.3 |
93.9 82.6 |
89.7 91.2 |
0.953 0.908 |
134.06 49.20 |
| Cho et al. 201323 | Korean | ANSUNG Cohort study/2009–10 | 45° nonmydriatic fundus photography | 40–60 (63.3 ±8.6) | 3,403 | 1.9 | HbA1c FPG |
6.6 6.0 |
76.2 69.8 |
84.2 77.1 |
0.830 0.730 |
17.06 7.78 |
| Xin et al. 201224 | China | Health Examination Survey in Beijing/2010–11 | 45° colour digital images | 18–79 | 2,551 | 2.9 | HbA1c FPG 2h-PG |
6.8 7.8 15.0 |
85.1 75.7 74.3 |
88.0 87.9 90.6 |
0.864 0.854 0.869 |
41.88 22.63 27.90 |
| Massin et al. 201125 | France | DESIR/1994–96 | Three nonmydriatic digital retinal photograph | 30–65 (52) | 700 | 3.2 | HbA1c FPG |
6.0 6.0 |
19.0 27.0 |
92.0 88.0 |
0.640 0.640 |
2.70 2.71 |
| Jonas et al. 201026 | China | BEIJING eye study/2006 | 45° nonstereoscopic photograph of central fundus | >45 (60.4±10.0) | 2,916 | 12.2 | FPG | 7.0 | 18.8 | 94.3 | 0.610 | 3.83 |
| Cheng et al. 200927 | USA | NHANES/2005–06 | Two 45° nonmydriatic colour digital retina image | >40 (56) | 1,066 | 11.0 | HbA1c FPG |
5.5 5.8 |
80.0 58.0 |
37.0 64.0 |
0.710 0.650 |
2.35 2.45 |
| Wong et al. 200828 | Australia, USA | BMES/1997–99; AusDiab/1999–2000; MESA/2002–04 |
six 30° retinal photographs two 45° retinal photographs |
>49 >25 45–84 |
3,162 2,182 6,079 |
11.5 9.6 15.8 |
FPGa FPGb FPGc |
7.0 7.0 7.0 |
14.8 39.0 24.4 |
95.8 80.8 91.4 |
0.560 0.610 0.600 |
3.96 2.70 3.42 |
| Miyazaki et al. 200429 | Japan | HISAYAMA study/1998 | 45° fundus photographs | 40–79 | 1,637 | 2.3 | HbA1c FPG 2h-PG |
5.7 6.4 11.1 |
86.5 86.5 86.5 |
90.1 87.3 89.6 |
0.945 0.900 0.960 |
58.30 44.04 78.90 |
| McCance et al. 199430 | USA (Pima Indian) | Gila River Indian Community/1982–90 | Direct ophthalmoscopy examination | >25 | 927 | 3.23 | HbA1c FPG 2h-PG |
7.8 9.3 12.6 |
65.6 68.8 87.5 |
87.6 87.7 80.2 |
0.821 0.822 0.841 |
13.47 15.72 28.35 |
a,b and c indicate different subgroups of participants in that study.