Accepted for/Published in: JMIR mHealth and uHealth
Date Submitted: Dec 16, 2019
Date Accepted: Apr 10, 2020
Evaluation of a novel device for smartphone-based fundus imaging for fundus documentation in clinical practice
ABSTRACT
Background:
Smartphone-based fundus imaging (SBFI) allows for mobile and inexpensive fundus examination with the potential to revolutionize eye care particularly in lower resources settings. Though, most SBFI adapters convey image quality not comparable to conventional fundus imaging devices (CFI).
Objective:
Evaluation of a novel SBFI device for documentation of a variety of retinal/vitreous pathology in a patient sample with a wide range of refraction and age.
Methods:
Participants were dilated and imaged with the iC2 funduscope (HEINE Optotechnik) using an Apple iPhone 6 in single-image acquisition (image resolution of 2448 x 3264 pixels) or video mode (1248 x 1664 pixels) and a subgroup also by CFI (Zeiss Visucam 500).
Results:
47 eyes from 32 participants (mean age 62.3 ± 19.8, range 7 to 93, mean spherical equivalent -0.78 ± 3.21 dpt, range -7.88 to +7.0 dpt) were included in the study. Mean visual acuity (logMAR) was 0.48 ± 0.66 (range 0 to 2.3). 30% of the eyes were pseudophakic. Image quality was sufficient in all eyes irrespective of refraction. Images acquired with CFI were sharper and there was no significant difference in reflex artifacts and contrast and illumination (p < .001, p = 1 and p = .07, respectively). When comparing image quality at the posterior pole, the mid periphery and the far periphery, glare increased as images were acquired from a more peripheral part of the retina. Reflex artifacts were more frequent in pseudophakic eyes. Image acquisition was also possible in children. Documentation of deep optic nerve cups in video mode conveyed a mock three-dimensional impression.
Conclusions:
High quality SBFI might represent a mobile alternative for fundus documentation in clinical practice.
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