Piyasena MMPN, et al. - Researchers estimated 700 people with diabetes (PwDM) of age > 18 years to analyze diagnostic test accuracy of diabetic retinopathy (DR) screening by physician graders (using a hand-held non-mydriatic retinal camera at a tertiary level medical clinic). They noted 43.4% of ungradable image proportion in non-mydriatic imaging (either eye-31.3%, both eyes 12.1%). Using mydriatic imaging, after including ungradable images as screen positives, they recorded the sensitivity of the defined referable DR 88.7% for grader 1 (positive predictive value [PPV] 59.1%) and 92.5% for grader 2 (PPV 68%). Whereas the specificity was noted 94.9% for grader 1 (negative predictive value [NPV] 99%) and 96.4% for grader 2 (NPV 99.4%) suggesting it an achievable alternative modality to the existing opportunistic screening.