![]() ![]() The agreement for macular edema was 88.48%, with a kappa of 0.809 (almost perfect). The agreement between devices for diabetic retinopathy classification was 73.18%, with a weighted kappa of 0.808 (almost perfect). Multivariate logistic regression analysis revealed a positive association between male sex (OR 1.687) and hypertension (OR 3.603) with referable diabetic retinopathy. Age ( P = .005), diabetes duration ( P = .004), body mass index ( P = .005), and hypertension ( P < .001) were statistically different between referable and non-referable patients. The mean age of participants was 57.03 years (SD 16.82, 9–90 years), and the mean duration of diabetes was 16.35 years (SD 9.69, 1–60 years). A univariate and stepwise multivariate logistic regression was performed to determine the relationship of each independent factor in referable diabetic retinopathy. ![]() The tabletop senior ophthalmologist adjudication label was used as the ground truth for comparative analysis. The International Classification of Diabetic Retinopathy was used for grading, and demographic data, diabetic retinopathy classification, artifacts, and image quality were compared between devices. All images were acquired by trained healthcare professionals, de-identified, and graded independently by two masked ophthalmologists, with a third senior ophthalmologist adjudicating in discordant cases. The participants underwent pharmacological mydriasis and fundus photography in two fields (macula and optic disk centered) with both strategies. This was a multicenter, cross-sectional study that included images from 327 individuals with diabetes.
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