Kesesuaian Penilaian Vision Threatening Diabetic Retinopathy Antara Dokter Umum, Residen Dan Konsulen Vitreoretina Dari Foto Fundus Berbasis Ponsel

IDHAYU ANGGIT W., dr. Muhammad Bayu Sasongko, Ph.D., Sp. M(K).; Prof. Dr. dr. Agus Supartoto, Sp. M(K)

2023 | Tesis-Spesialis | ILMU KESEHATAN MATA

Tujuan Mengetahui kesesuaian penilaian vision threatening diabetic retinopathy antara dokter umum, residen dan konsulen vitreoretina dari foto fundus berbasis ponsel Metode Penelitian dengan desain potong lintang pada 410 foto fundus dari 270 pasien DM di fasilitas kesehatan primer, sekunder dan tersier. Foto fundus berbasis ponsel dan tabletop dengan kriteria acceptable dan excellent dinilai berdasarkan kriteria ICO oleh konsulen vitreoretina dan didapatkan 196 foto observasi dan 214 foto rujuk VTDR sebagai kunci. Foto fundus yang sama dinilai observasi atau rujuk VTDR oleh konsulen vitreoretina (penilai 1 dan 2) sebagai standar baku dan dinilai kesesuaiannya dengan residen (penilai 3 dan 4) dan dokter umum (penilai 5 dan 6). Hasil Penilaian foto fundus oleh kunci dan konsulen vitreoretina (kunci: penilai 1: penilai 2) terdapat foto observasi (196:165:170) dan foto rujuk VTDR (214:211:206) dengan nilai kappa sebesar 0,83 (almost perfect agreement). Substantial agreement penilaian VTDR antara konsulen vitreoretina (penilai 1 dan 2) dengan residen (penilai 3 dan 4). Kesesuaian konsulen vitreoretina (penilai 1 dan 2) dengan dokter umum (penilai 5) memiliki almost perfect agreement, sedangkan dengan dokter umum (penilai 6) substantial agreement. Kesimpulan Penilaian Vision Threatening Diabetic Retinopathy (VTDR) antara penilai dokter umum, residen dan konsulen vitreoretina menggunakan citra foto fundus berbasis ponsel menunjukkan kesesuaian sangat baik (good agreement).

Objective To find agreement of vision threatening diabetic retinopathy between general practitioners, ophthalmologist trainees and vitreoretina consultants from phone based fundus photos. Methods This was a cross-sectional study with 410 fundus photos from 270 patients with DM in primary, secondary and tertiary health care. 196 observed eye photos and 214 referred VTDR eye photos are obtained by vitroretina consultans assessment. Those are categorized as acceptable and excellent phone-based and tabletop fundus photos using ICO criteria and then designated as key. Thus, phone based fundus photo assessed by vitreoretina consultants (grader 1 and 2) is designated as gold standard and finds agreement to ophtalmologist trainees (grader 3 and 4) and general practitioners (grader 5 and 6). Results Fundus photo assessment by keys and vitreoretina consultants (keys: grader 1: grader 2) observed eye photo (196:165:170) and referred VTDR eye photo (214:211:206) has kappa value 0,83 (almost perfect agreement). Substantial agreement of VTDR between vitreoretina consultants (grader 1 and 2) and opthalmologist trainees (grader 3 dan 4) is found. Meanwhile, almost perfect agreement is found between vitreoretina consultants (grader 1 and 2) and general practitioner (grader 5) but only is substantial agreement with general practitioner (grader 6) found. Conclusion Good agreement of Vision Threatening Diabetic Retinopathy (VTDR) assessment between general practitioners, ophthalmologist trainees and vitreoretina consultants from phone-based fundus photo is found.

Kata Kunci : VTDR, foto fundus, berbasis ponsel, fundus photo, phone based