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Am J Ophthalmol. 2015 Feb;159(2):360-4.e1. doi: 10.1016/j.ajo.2014.11.008. Epub 2014 Nov 7.

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

Author information

1
Eye Clinic, Department of Neurological and Vision Sciences, University of Brescia, Brescia, Italy. Electronic address: dott.andrea.russo@gmail.com.
2
Eye Clinic, Department of Neurological and Vision Sciences, University of Brescia, Brescia, Italy.
3
Eye Clinic, Department of Health Sciences, University of Molise, Campobasso, Italy.

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.

PMID:
25447109
DOI:
10.1016/j.ajo.2014.11.008
[Indexed for MEDLINE]

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