Non-mydriatic Digital Macular Photography: How Good is the Second Eye Photograph?

Purpose: In an elderly Australian population, to evaluate the quality of fundus photographs taken non-mydriatically in both eyes, and to compare the quality of those taken second with those taken first. Methods: From 2258 participants (4516 images) aged 70 years and older who participated in the Melbourne Collaborative Cohort Study (MCCS), digital non-stereoscopic 45 degrees retinal photographs were taken with a Canon CR6-45NM Non-mydriatic Retinal Camera and evaluated. The quality of macular images was assessed as good, fair, and poor and McNemar's test was used to analyze variation in quality. Results: Gradable quality images were obtained from 95.8% eyes of participants, with 93.9% of participants having gradable photos of both eyes. The gradable rate for the eye photographed first (right), was significantly higher than that for the eye photographed second (left): 89.7% vs. 85.6%, respectively (difference of 4.12%, confidence interval [CI] of 2.68-5.54%, p < 0.001). The rate of ungradable photographs from the second eye was slightly greater than the first eye (4.5% and 3.8%, respectively), but the difference in proportion was not statistically significant (difference of 3.6%, Cl of 0.17-1.5%, p = 0.384). Conclusions: In the setting of a large elderly cohort study, non-dilated 45 degrees digital retinal imaging is an excellent method for fundus examination. It is fast, easy to use, non-invasive, and a reliable AMD (age-related macular degeneration)-detecting technique with only a minor loss of information from the second eye.