Clinical validation of a smartphone-based handheld fundus camera for the evaluation of optic nerve head

Detalhes bibliográficos
Autor(a) principal: Titoneli,Carolina C.
Data de Publicação: 2021
Outros Autores: Filho,Marcio S., Lencione,Diego, Vieira,Flavio Pascoal, Stuchi,José Augusto, Paula,Jayter S.
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Arquivos brasileiros de oftalmologia (Online)
Texto Completo: http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0004-27492021000600531
Resumo: ABSTRACT Purpose: To compare the quality of retinal images captured with a smartphone-based, handheld fundus camera with that of retinal images captured with a commercial fundus camera and to analyze their agreement in determining the cup-to-disc ratio for a cohort of ophthalmological patients. Methods: A total of 50 patients from a secondary ophthalmic outpatient service center underwent a bilateral fundus examination under mydriasis with a smartphone-based, handheld fundus camera and with a commercial fundus camera (4 images/patient by each). Two experienced ophthalmologists evaluated all the fundus images and graded them on the Likert 1-5 scale for quality. Multivariate regression analyses was then performed to evaluate the factors associated with the image quality. Two masked ophthalmologists determined the vertical cup-to-disc ratio of each fundus image, and both the intraobserver (between devices) and interobserver agreement between them was calculated. Results: Ninety-eight images from 49 patients were processed in this study for their quality analysis. Ten images from five patients (four from commercial fundus camera and one from smartphone-based, handheld fundus camera) were not included in the analyses due to their extremely poor quality. The medians [interquartile interval] of the image quality were not significantly different between those from the smartphone-based, handheld fundus camera and from the commercial fundus camera (4 [4-5] versus 4 [3-4] respectively, p=0.06); however, both the images captured with the commercial fundus camera and the presence of media opacity presented a significant negative correlation with the image quality. Both the intraobserver [intraclass correlation coefficient (ICC)=0.82, p<0.001 and 0.83, p<0.001, for examiners 1 and 2, respectively] and interobserver (ICC=0.70, p=0.001 and 0.81; p<0.001, for smartphone-based handheld fundus camera and commercial fundus camera, respectively) agreements were excellent and statistically significant. Conclusions: Our results thus indicate that the smartphone-based, handheld fundus camera yields an image quality similar to that from a commercial fundus camera, with significant agreement in the cup-to-disc ratios between them. In addition to the good outcomes recorded, the smartphone-based, handheld fundus camera offers the advantages of portability and low-cost to serve as an alternative for fundus documentation for future telemedicine approaches in medical interventions.
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spelling Clinical validation of a smartphone-based handheld fundus camera for the evaluation of optic nerve headPhotography/instrumentationSmartphoneOptic nerveTelemedicineABSTRACT Purpose: To compare the quality of retinal images captured with a smartphone-based, handheld fundus camera with that of retinal images captured with a commercial fundus camera and to analyze their agreement in determining the cup-to-disc ratio for a cohort of ophthalmological patients. Methods: A total of 50 patients from a secondary ophthalmic outpatient service center underwent a bilateral fundus examination under mydriasis with a smartphone-based, handheld fundus camera and with a commercial fundus camera (4 images/patient by each). Two experienced ophthalmologists evaluated all the fundus images and graded them on the Likert 1-5 scale for quality. Multivariate regression analyses was then performed to evaluate the factors associated with the image quality. Two masked ophthalmologists determined the vertical cup-to-disc ratio of each fundus image, and both the intraobserver (between devices) and interobserver agreement between them was calculated. Results: Ninety-eight images from 49 patients were processed in this study for their quality analysis. Ten images from five patients (four from commercial fundus camera and one from smartphone-based, handheld fundus camera) were not included in the analyses due to their extremely poor quality. The medians [interquartile interval] of the image quality were not significantly different between those from the smartphone-based, handheld fundus camera and from the commercial fundus camera (4 [4-5] versus 4 [3-4] respectively, p=0.06); however, both the images captured with the commercial fundus camera and the presence of media opacity presented a significant negative correlation with the image quality. Both the intraobserver [intraclass correlation coefficient (ICC)=0.82, p<0.001 and 0.83, p<0.001, for examiners 1 and 2, respectively] and interobserver (ICC=0.70, p=0.001 and 0.81; p<0.001, for smartphone-based handheld fundus camera and commercial fundus camera, respectively) agreements were excellent and statistically significant. Conclusions: Our results thus indicate that the smartphone-based, handheld fundus camera yields an image quality similar to that from a commercial fundus camera, with significant agreement in the cup-to-disc ratios between them. In addition to the good outcomes recorded, the smartphone-based, handheld fundus camera offers the advantages of portability and low-cost to serve as an alternative for fundus documentation for future telemedicine approaches in medical interventions.Conselho Brasileiro de Oftalmologia2021-12-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S0004-27492021000600531Arquivos Brasileiros de Oftalmologia v.84 n.6 2021reponame:Arquivos brasileiros de oftalmologia (Online)instname:Conselho Brasileiro de Oftalmologia (CBO)instacron:CBO10.5935/0004-2749.20210080info:eu-repo/semantics/openAccessTitoneli,Carolina C.Filho,Marcio S.Lencione,DiegoVieira,Flavio PascoalStuchi,José AugustoPaula,Jayter S.eng2021-11-18T00:00:00Zoai:scielo:S0004-27492021000600531Revistahttp://aboonline.org.br/https://old.scielo.br/oai/scielo-oai.phpaboonline@cbo.com.br||abo@cbo.com.br1678-29250004-2749opendoar:2021-11-18T00:00Arquivos brasileiros de oftalmologia (Online) - Conselho Brasileiro de Oftalmologia (CBO)false
dc.title.none.fl_str_mv Clinical validation of a smartphone-based handheld fundus camera for the evaluation of optic nerve head
title Clinical validation of a smartphone-based handheld fundus camera for the evaluation of optic nerve head
spellingShingle Clinical validation of a smartphone-based handheld fundus camera for the evaluation of optic nerve head
Titoneli,Carolina C.
Photography/instrumentation
Smartphone
Optic nerve
Telemedicine
title_short Clinical validation of a smartphone-based handheld fundus camera for the evaluation of optic nerve head
title_full Clinical validation of a smartphone-based handheld fundus camera for the evaluation of optic nerve head
title_fullStr Clinical validation of a smartphone-based handheld fundus camera for the evaluation of optic nerve head
title_full_unstemmed Clinical validation of a smartphone-based handheld fundus camera for the evaluation of optic nerve head
title_sort Clinical validation of a smartphone-based handheld fundus camera for the evaluation of optic nerve head
author Titoneli,Carolina C.
author_facet Titoneli,Carolina C.
Filho,Marcio S.
Lencione,Diego
Vieira,Flavio Pascoal
Stuchi,José Augusto
Paula,Jayter S.
author_role author
author2 Filho,Marcio S.
Lencione,Diego
Vieira,Flavio Pascoal
Stuchi,José Augusto
Paula,Jayter S.
author2_role author
author
author
author
author
dc.contributor.author.fl_str_mv Titoneli,Carolina C.
Filho,Marcio S.
Lencione,Diego
Vieira,Flavio Pascoal
Stuchi,José Augusto
Paula,Jayter S.
dc.subject.por.fl_str_mv Photography/instrumentation
Smartphone
Optic nerve
Telemedicine
topic Photography/instrumentation
Smartphone
Optic nerve
Telemedicine
description ABSTRACT Purpose: To compare the quality of retinal images captured with a smartphone-based, handheld fundus camera with that of retinal images captured with a commercial fundus camera and to analyze their agreement in determining the cup-to-disc ratio for a cohort of ophthalmological patients. Methods: A total of 50 patients from a secondary ophthalmic outpatient service center underwent a bilateral fundus examination under mydriasis with a smartphone-based, handheld fundus camera and with a commercial fundus camera (4 images/patient by each). Two experienced ophthalmologists evaluated all the fundus images and graded them on the Likert 1-5 scale for quality. Multivariate regression analyses was then performed to evaluate the factors associated with the image quality. Two masked ophthalmologists determined the vertical cup-to-disc ratio of each fundus image, and both the intraobserver (between devices) and interobserver agreement between them was calculated. Results: Ninety-eight images from 49 patients were processed in this study for their quality analysis. Ten images from five patients (four from commercial fundus camera and one from smartphone-based, handheld fundus camera) were not included in the analyses due to their extremely poor quality. The medians [interquartile interval] of the image quality were not significantly different between those from the smartphone-based, handheld fundus camera and from the commercial fundus camera (4 [4-5] versus 4 [3-4] respectively, p=0.06); however, both the images captured with the commercial fundus camera and the presence of media opacity presented a significant negative correlation with the image quality. Both the intraobserver [intraclass correlation coefficient (ICC)=0.82, p<0.001 and 0.83, p<0.001, for examiners 1 and 2, respectively] and interobserver (ICC=0.70, p=0.001 and 0.81; p<0.001, for smartphone-based handheld fundus camera and commercial fundus camera, respectively) agreements were excellent and statistically significant. Conclusions: Our results thus indicate that the smartphone-based, handheld fundus camera yields an image quality similar to that from a commercial fundus camera, with significant agreement in the cup-to-disc ratios between them. In addition to the good outcomes recorded, the smartphone-based, handheld fundus camera offers the advantages of portability and low-cost to serve as an alternative for fundus documentation for future telemedicine approaches in medical interventions.
publishDate 2021
dc.date.none.fl_str_mv 2021-12-01
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
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dc.identifier.uri.fl_str_mv http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0004-27492021000600531
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dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv 10.5935/0004-2749.20210080
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
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dc.publisher.none.fl_str_mv Conselho Brasileiro de Oftalmologia
publisher.none.fl_str_mv Conselho Brasileiro de Oftalmologia
dc.source.none.fl_str_mv Arquivos Brasileiros de Oftalmologia v.84 n.6 2021
reponame:Arquivos brasileiros de oftalmologia (Online)
instname:Conselho Brasileiro de Oftalmologia (CBO)
instacron:CBO
instname_str Conselho Brasileiro de Oftalmologia (CBO)
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institution CBO
reponame_str Arquivos brasileiros de oftalmologia (Online)
collection Arquivos brasileiros de oftalmologia (Online)
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