·AIM:To evaluate the ability of digital fundus photography and direct funduscopy to detect diabetic retinopathy(DR)in patients with diabetic mellitus(DM)compared with fundus fluorescein angiography(FFA).·METHODS:All 264 cases with diabetes underwent non-mydriatic digital fundus photography,FFA,and direct funduscopy with dilation of their pupils.Then statistics contrast study of direct funduscopy and FFA,non-mydriatic digital fundus photography and FFA were carried out respectively.· RESULTS:In comparison with FFA,mild nonproliferative DR being taken as referable DR,direct funduscopy with dilation of pupils gave a sensitivity of 63.4%,a specificity of 76.9%,and a Kappa statistic of 41.9%,a Youden of 41.1%,digital fundus photography gave a sensitivity of 86.8%,a specificity of 92.3%,and a Kappa statistic of 80.7%,a Youden of 79.1%;moderate nonproliferative DR being taken as referable DR,direct funduscopy with dilation of pupils gave a sensitivity of 65.5%,a specificity of 94.7%,and a Kappa statistic of 39.1%,a Youden of 60.3%,and digital fundus photography gave a sensitivity of 93.1%,a specificity of 97.4%,and a Kappa statistic of 61.2%,a Youden of 90.5%.·CONCLUSION:Digital fundus photography centered at fovea for screening of early DR especially stage DR Ⅱ or more severe.·