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Validation of Smartphone Based Retinal Photography for Diabetic Retinopathy Screening.

Rajalakshmi R, Arulmalar S, Usha M, Prathiba V, Kareemuddin KS, Anjana RM, Mohan V - PLoS ONE (2015)

Bottom Line: The Zeiss camera showed that 43.9% had non-proliferative DR(NPDR) and 15.3% had PDR while the FOP camera showed that 40.2% had NPDR and 15.3% had PDR.The sensitivity and specificity for detecting any DR by FOP was 92.7% (95%CI 87.8-96.1) and 98.4% (95%CI 94.3-99.8) respectively and the kappa (ĸ) agreement was 0.90 (95%CI-0.85-0.95 p<0.001) while for STDR, the sensitivity was 87.9% (95%CI 83.2-92.9), specificity 94.9% (95%CI 89.7-98.2) and ĸ agreement was 0.80 (95%CI 0.71-0.89 p<0.001), compared to conventional photography.Retinal photography using FOP camera is effective for screening and diagnosis of DR and STDR with high sensitivity and specificity and has substantial agreement with conventional retinal photography.

View Article: PubMed Central - PubMed

Affiliation: Madras Diabetes Research Foundation & Dr.Mohan's Diabetes Specialities Centre, WHO Collaborating Centre for Non-communicable Diseases Prevention and Control, IDF Centre of Education, Gopalapuram, Chennai, India.

ABSTRACT

Aim: To evaluate the sensitivity and specificity of "fundus on phone' (FOP) camera, a smartphone based retinal imaging system, as a screening tool for diabetic retinopathy (DR) detection and DR severity in comparison with 7-standard field digital retinal photography.

Design: Single-site, prospective, comparative, instrument validation study.

Methods: 301 patients (602 eyes) with type 2 diabetes underwent standard seven-field digital fundus photography with both Carl Zeiss fundus camera and indigenous FOP at a tertiary care diabetes centre in South India. Grading of DR was performed by two independent retina specialists using modified Early Treatment of Diabetic Retinopathy Study grading system. Sight threatening DR (STDR) was defined by the presence of proliferative DR(PDR) or diabetic macular edema. The sensitivity, specificity and image quality were assessed.

Results: The mean age of the participants was 53.5 ±9.6 years and mean duration of diabetes 12.5±7.3 years. The Zeiss camera showed that 43.9% had non-proliferative DR(NPDR) and 15.3% had PDR while the FOP camera showed that 40.2% had NPDR and 15.3% had PDR. The sensitivity and specificity for detecting any DR by FOP was 92.7% (95%CI 87.8-96.1) and 98.4% (95%CI 94.3-99.8) respectively and the kappa (ĸ) agreement was 0.90 (95%CI-0.85-0.95 p<0.001) while for STDR, the sensitivity was 87.9% (95%CI 83.2-92.9), specificity 94.9% (95%CI 89.7-98.2) and ĸ agreement was 0.80 (95%CI 0.71-0.89 p<0.001), compared to conventional photography.

Conclusion: Retinal photography using FOP camera is effective for screening and diagnosis of DR and STDR with high sensitivity and specificity and has substantial agreement with conventional retinal photography.

No MeSH data available.


Related in: MedlinePlus

Fundus cameras.
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pone.0138285.g001: Fundus cameras.

Mentions: The participants then underwent a 4 field retinal colour photography using the “Fundus on Phone” (FOP) smartphone based retinal imaging system (Remidio Innovative Solutions Pvt Ltd, Bangalore). The fields which were captured on the FOP camera were macula, disc and nasal to the optic disc, superior-temporal and inferior-temporal quadrants [7]. The FOP is a portable retinal camera capable of being used in both clinical set-up and in field settings. It consists of an annular illumination optical design which mates with a commercially available smart phone to acquire and transmit retinal images (Fig 1). The illumination design ensures reflex-free images of the retina, in a compact format, and it is much smaller than the traditional fundus cameras (Fig 1). FOP has a 45 degree field of view, a 33 mm working distance, +20 to -20 dioptre adjustment and an optical magnification of 12X. The sensor resolution is governed by the smart phone. The device can be fit onto any standard slit lamp as shown in Fig 1. The auto-focus of the camera app, allows for sharp images of the retina to be taken, using the smartphone’s touch interface. An android app allows all data of the patient to be stored folder wise on the phone enabling easy archival and retrieval. Each photograph has patient data in the corner to prevent any mix ups during the acquisition, transfer and reporting process. Unlike traditional fundus cameras, that operate using a xenon flash, the illumination on FOP uses a warm-white LED that has a life of more than 50,000 hrs. However the device does not have a mechanical tilt, as is typically available in the Zeiss fundus camera.


Validation of Smartphone Based Retinal Photography for Diabetic Retinopathy Screening.

Rajalakshmi R, Arulmalar S, Usha M, Prathiba V, Kareemuddin KS, Anjana RM, Mohan V - PLoS ONE (2015)

Fundus cameras.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4581835&req=5

pone.0138285.g001: Fundus cameras.
Mentions: The participants then underwent a 4 field retinal colour photography using the “Fundus on Phone” (FOP) smartphone based retinal imaging system (Remidio Innovative Solutions Pvt Ltd, Bangalore). The fields which were captured on the FOP camera were macula, disc and nasal to the optic disc, superior-temporal and inferior-temporal quadrants [7]. The FOP is a portable retinal camera capable of being used in both clinical set-up and in field settings. It consists of an annular illumination optical design which mates with a commercially available smart phone to acquire and transmit retinal images (Fig 1). The illumination design ensures reflex-free images of the retina, in a compact format, and it is much smaller than the traditional fundus cameras (Fig 1). FOP has a 45 degree field of view, a 33 mm working distance, +20 to -20 dioptre adjustment and an optical magnification of 12X. The sensor resolution is governed by the smart phone. The device can be fit onto any standard slit lamp as shown in Fig 1. The auto-focus of the camera app, allows for sharp images of the retina to be taken, using the smartphone’s touch interface. An android app allows all data of the patient to be stored folder wise on the phone enabling easy archival and retrieval. Each photograph has patient data in the corner to prevent any mix ups during the acquisition, transfer and reporting process. Unlike traditional fundus cameras, that operate using a xenon flash, the illumination on FOP uses a warm-white LED that has a life of more than 50,000 hrs. However the device does not have a mechanical tilt, as is typically available in the Zeiss fundus camera.

Bottom Line: The Zeiss camera showed that 43.9% had non-proliferative DR(NPDR) and 15.3% had PDR while the FOP camera showed that 40.2% had NPDR and 15.3% had PDR.The sensitivity and specificity for detecting any DR by FOP was 92.7% (95%CI 87.8-96.1) and 98.4% (95%CI 94.3-99.8) respectively and the kappa (ĸ) agreement was 0.90 (95%CI-0.85-0.95 p<0.001) while for STDR, the sensitivity was 87.9% (95%CI 83.2-92.9), specificity 94.9% (95%CI 89.7-98.2) and ĸ agreement was 0.80 (95%CI 0.71-0.89 p<0.001), compared to conventional photography.Retinal photography using FOP camera is effective for screening and diagnosis of DR and STDR with high sensitivity and specificity and has substantial agreement with conventional retinal photography.

View Article: PubMed Central - PubMed

Affiliation: Madras Diabetes Research Foundation & Dr.Mohan's Diabetes Specialities Centre, WHO Collaborating Centre for Non-communicable Diseases Prevention and Control, IDF Centre of Education, Gopalapuram, Chennai, India.

ABSTRACT

Aim: To evaluate the sensitivity and specificity of "fundus on phone' (FOP) camera, a smartphone based retinal imaging system, as a screening tool for diabetic retinopathy (DR) detection and DR severity in comparison with 7-standard field digital retinal photography.

Design: Single-site, prospective, comparative, instrument validation study.

Methods: 301 patients (602 eyes) with type 2 diabetes underwent standard seven-field digital fundus photography with both Carl Zeiss fundus camera and indigenous FOP at a tertiary care diabetes centre in South India. Grading of DR was performed by two independent retina specialists using modified Early Treatment of Diabetic Retinopathy Study grading system. Sight threatening DR (STDR) was defined by the presence of proliferative DR(PDR) or diabetic macular edema. The sensitivity, specificity and image quality were assessed.

Results: The mean age of the participants was 53.5 ±9.6 years and mean duration of diabetes 12.5±7.3 years. The Zeiss camera showed that 43.9% had non-proliferative DR(NPDR) and 15.3% had PDR while the FOP camera showed that 40.2% had NPDR and 15.3% had PDR. The sensitivity and specificity for detecting any DR by FOP was 92.7% (95%CI 87.8-96.1) and 98.4% (95%CI 94.3-99.8) respectively and the kappa (ĸ) agreement was 0.90 (95%CI-0.85-0.95 p<0.001) while for STDR, the sensitivity was 87.9% (95%CI 83.2-92.9), specificity 94.9% (95%CI 89.7-98.2) and ĸ agreement was 0.80 (95%CI 0.71-0.89 p<0.001), compared to conventional photography.

Conclusion: Retinal photography using FOP camera is effective for screening and diagnosis of DR and STDR with high sensitivity and specificity and has substantial agreement with conventional retinal photography.

No MeSH data available.


Related in: MedlinePlus