Abstract: Objective  To compare the sensitivity and specificity of single-field fundus photography and multiple-field fundus photography with FFA in grading diabetic retinopathy. Design Diagnostic test. Participants Eighty-five cases (162 eyes) with diabetes over 18 years old in Department of Ophthalmology of Beijing Tongren Hospital were selected. Methods Nonmydriatic single-field digital fundus photography, mydriatic two-field fundus photography, nine-field fundus photography and FFA were performed in all subjects. Grading of diabetic retinopathy was carried out by two ophthalmologists according to diabetic retinopathy international clinical classification. Main Outcome Measures Kappa value, sensitivity, specificity. Results The Kappa value of two ophthalmologists on single-field, two-field, nine-field fundus photography was 0.58, 0.79, 0.79 respectively. The sensitivity of  single-field, two- field, nine-field fundus photography for detecting the presence of diabetic retinopathy was 95.7%, 98.6, 100% respectively， and the specificity was 100%. The sensitivity of single-field, two-field, nine-field fundus photography for detecting the presence of severe non-proljferative diabetic retinopathy (NPDR) or more serious was 57.9%, 60.5%, 71.1% respectively, and the specificity was 100%. Conclusion The sensitivity of single-field fundus photography for the presence of diabetic retinopathy is more than 95%, and nearly 2/3 of NPDR or more serious can be accurately graded.

Key words: diabetic retinopathy/diagnosis, fundus photography, consistency