Comparison of smartphone ophthalmoscopy with slit-lamp biomicroscopy for grading diabetic retinopathy.

Abstract

PURPOSE:

To assess the accuracy and reliability of smartphone ophthalmoscopy, we compared the ability of a smartphone ophthalmoscope with that of a slit-lamp biomicroscope to grade diabetic retinopathy (DR) in patients with diabetes mellitus (DM).

DESIGN:

Clinical-based, prospective, comparative instrument study.

METHODS:

This comparative clinical study was performed in 120 outpatients (240 eyes) with type 1 or type 2 DM. After pupil dilation, the patients underwent smartphone ophthalmoscopy with the D-Eye device, followed by dilated retinal slit-lamp examination, to grade DR according to a 5-step scale.

RESULTS:

Overall exact agreement between the 2 methods was observed in 204 of 240 eyes (85%) (simple κ = 0.78; CI 0.71-0.84) and agreement within 1 step was observed in 232 eyes (96.7%). Compared to biomicroscopy, the sensitivity and specificity of smartphone ophthalmoscopy for the detection of clinically significant macular edema were 81% and 98%, respectively. Smartphone ophthalmoscopy and biomicroscopy could not be used to examine the fundus and grade DR in 9 eyes (3.75%) and 4 eyes (1.7%), respectively, because of cataract and/or small pupil diameter.

CONCLUSION:

Smartphone ophthalmoscopy showed considerable agreement with dilated retinal biomicroscopy for the grading of DR. The portability, affordability, and connectivity of a smartphone ophthalmoscope make smartphone ophthalmoscopy a promising technique for community screening programs.

• Authors: Andrea Russo, Francesco Morescalchi, Ciro Costagliola, Luisa Delcassi, Francesco Semeraro
• Journal: American journal of ophthalmology (Am J Ophthalmol) Vol. 159 Issue 2 Pg. 360-4.e1 (Feb 2015) ISSN: 1879-1891 [Electronic] United States
• PMID: 25447109 (Publication Type: Comparative Study, Journal Article)
• Copyright: Copyright © 2015 Elsevier Inc. All rights reserved.

Chemical References

• Mydriatics
• Phenylephrine
• Tropicamide

Topics

• Adult
• Aged
• Cell Phone (instrumentation)
• Diabetes Complications
• Diabetic Retinopathy (classification)
• Female
• Humans
• Macular Edema (diagnosis)
• Male
• Middle Aged
• Mydriatics (administration & dosage)
• Ophthalmoscopy (methods)
• Phenylephrine (administration & dosage)
• Prospective Studies
• Pupil (drug effects)
• Reproducibility of Results
• Sensitivity and Specificity
• Slit Lamp
• Tropicamide (administration & dosage)