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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

Retinal images of diabetic retinopathy obtained in fundus on phone (FOP) and Zeiss camera.
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pone.0138285.g002: Retinal images of diabetic retinopathy obtained in fundus on phone (FOP) and Zeiss camera.

Mentions: The overall prevalence of DR based on retinal photography by Zeiss fundus camera and FOP camera was 59.1% and 55.5% respectively. The DR detection matched in 165 out of 178 (92.7%) patients. Conventional fundus photograph 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 varying grades of diabetic retinopathy in the two modes of retinal photography are depicted in Table 1. DME was present in 82 (27.2%) patients based on the grading in both cameras. The agreement matched between the 2 cameras in 71 (86.6%) patients with DME. Fig 2shows the retinal images of varying degrees of severity of DR taken on FOP and 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)

Retinal images of diabetic retinopathy obtained in fundus on phone (FOP) and Zeiss camera.
© Copyright Policy
Related In: Results  -  Collection

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

pone.0138285.g002: Retinal images of diabetic retinopathy obtained in fundus on phone (FOP) and Zeiss camera.
Mentions: The overall prevalence of DR based on retinal photography by Zeiss fundus camera and FOP camera was 59.1% and 55.5% respectively. The DR detection matched in 165 out of 178 (92.7%) patients. Conventional fundus photograph 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 varying grades of diabetic retinopathy in the two modes of retinal photography are depicted in Table 1. DME was present in 82 (27.2%) patients based on the grading in both cameras. The agreement matched between the 2 cameras in 71 (86.6%) patients with DME. Fig 2shows the retinal images of varying degrees of severity of DR taken on FOP and 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