This article is more than 5 years old. Information may no longer be current.
Study shows smartphone ophthalmoscopy agrees with slit lamp biomicroscopy
Researchers found good agreement between smartphone ophthalmoscopy and slit lamp biomicroscopy when evaluating vertical cup-to-disc ratios in patients with ocular hypertension and primary open-angle glaucoma.
The comparative instrument study published in the Journal of Glaucoma included 110 patients with ocular hypertension or primary open-angle glaucoma. Vertical cup-to-disc ratio estimations were completed by undilated smartphone ophthalmoscopy (D-EYE, Padova, Italy) and slit-lamp biomicroscopy by two masked glaucoma specialists.
The differences between the mean vertical cup-to-disc ratio estimations obtained by the two methods were not statistically significant, according to researchers.
Overall exact agreement between the two modalities was found in 21 of 29 eyes in primary open-angle glaucoma patients and in 52 of 78 eyes in ocular hypertension patients, researchers said.
“Although optic nerve head examination is best performed through a dilated pupil, smartphone ophthalmoscopy is intended to serve as a tool to enable detection of disease in patients with poor access to ophthalmologic care,” the researchers wrote.
“The fast acquisition time per eye (12.8 seconds) could make the smartphone ophthalmoscopy a promising tool for glaucoma assessment in community screening programs, even by nonophthalmic personnel exploiting the wireless connectivity of smartphone in a telemedicine scenario,” the researchers concluded. – by Abigail Sutton
Disclosure: The researchers reported no financial disclosures.
Perspective
Back to Top
Cell phones have become ubiquitous. This ready availability combined with portability and connectivity features makes cell phone use for medical screening a tantalizing prospect, especially in remote areas that lack appropriate health care.
In this study, Russo and colleagues utilized undilated optic nerve photos obtained via a cell phone and compared the vertical CD ratio (VCDR) from the photos to VCDRs obtained via direct observation with biomicroscopy. The difference between the two assessments was negligible and would seem to indicate that the use of this type of technology and screening process may be feasible.
The limitations of the study were that the patient population was relatively young with no significant cataract development, and the only parameter assessed was the VCDR.
Glaucoma is a silent, potentially blinding disease, and worldwide, population-based studies suggest that at least 50% of affected individuals are undiagnosed. The use of ubiquitous cell phone technology as a screening tool for glaucoma provides a novel and, I think, exciting approach to a concerning problem.