15 April 2015
Smartphone Ophthalmoscopy vs. Slit Lamp Biomicroscope
To assess the accuracy and reliability of smartphone ophthalmoscopy, investigators conducted this clinical-based, prospective, comparative instrument study to compare the ability of a smartphone ophthalmoscope with that of a slit lamp biomicroscope to grade diabetic retinopathy in patients with diabetes mellitus.
They performed this comparative clinical study 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 five-step scale.
Overall, the investigators observed exact agreement between the two methods in 204 of 240 eyes (85%) (simple κ=0.78; CI 0.71 to 0.84) and agreement within one step in 232 eyes (96.7%). They reported that compared to biomicroscopy, the sensitivity and specificity of smartphone ophthalmoscopy for the detection of clinically significant macular edema were 81% and 98%, respectively. Moreover, smartphone ophthalmoscopy and biomicroscopy could not be used to examine the fundus and grade DR in nine eyes (3.75%) and four eyes (1.7%), respectively, because of cataract and/or small pupil diameter.
In 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.