Dataset Information

Smartphone-Based, Rapid, Wide-Field Fundus Photography for Diagnosis of Pediatric Retinal Diseases.

ABSTRACT: Purpose:An important, unmet clinical need is for cost-effective, reliable, easy-to-use, and portable retinal photography to evaluate preventable causes of vision loss in children. This study presents the feasibility of a novel smartphone-based retinal imaging device tailored to imaging the pediatric fundus. Methods:Several modifications for children were made to our previous device, including a child-friendly 3D printed housing of animals, attention-grabbing targets, enhanced image stitching, and video-recording capabilities. Retinal photographs were obtained in children undergoing routine dilated eye examination. Experienced masked retina-specialist graders determined photograph quality and made diagnoses based on the images, which were compared to the treating clinician's diagnosis. Results:Dilated fundus photographs were acquired in 43 patients with a mean age of 6.7 years. The diagnoses included retinoblastoma, Coats' disease, commotio retinae, and optic nerve hypoplasia, among others. Mean time to acquire five standard photographs totaling 90-degree field of vision was 2.3 ± 1.1 minutes. Patients rated their experience of image acquisition favorably, with a Likert score of 4.6 ± 0.8 out of 5. There was 96% agreement between image-based diagnosis and the treating clinician's diagnosis. Conclusions:We report a handheld smartphone-based device with modifications tailored for wide-field fundus photography in pediatric patients that can rapidly acquire fundus photos while being well-tolerated. Translational Relevance:Advances in handheld smartphone-based fundus photography devices decrease the technical barrier for image acquisition in children and may potentially increase access to ophthalmic care in communities with limited resources.

SUBMITTER: Patel TP

PROVIDER: S-EPMC6543857 | biostudies-literature | 2019 May

REPOSITORIES: biostudies-literature

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Smartphone-Based, Rapid, Wide-Field Fundus Photography for Diagnosis of Pediatric Retinal Diseases.

Patel Tapan P TP Kim Tyson N TN Yu Gina G Dedania Vaidehi S VS Lieu Philip P Qian Cynthia X CX Besirli Cagri G CG Demirci Hakan H Margolis Todd T Fletcher Daniel A DA Paulus Yannis M YM

Translational vision science & technology 20190530 3

<h4>Purpose</h4>An important, unmet clinical need is for cost-effective, reliable, easy-to-use, and portable retinal photography to evaluate preventable causes of vision loss in children. This study presents the feasibility of a novel smartphone-based retinal imaging device tailored to imaging the pediatric fundus.<h4>Methods</h4>Several modifications for children were made to our previous device, including a child-friendly 3D printed housing of animals, attention-grabbing targets, enhanced imag ...[more]

PMID: 31171996

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Project description:Hemispherical photography (HP), implemented with cameras equipped with "fisheye" lenses, is a widely used method for describing forest canopies and light regimes. A promising technological advance is the availability of low-cost fisheye lenses for smartphone cameras. However, smartphone camera sensors cannot record a full hemisphere. We investigate whether smartphone HP is a cheaper and faster but still adequate operational alternative to traditional cameras for describing forest canopies and light regimes. We collected hemispherical pictures with both smartphone and traditional cameras in 223 forest sample points, across different overstory species and canopy densities. The smartphone image acquisition followed a faster and simpler protocol than that for the traditional camera. We automatically thresholded all images. We processed the traditional camera images for Canopy Openness (CO) and Site Factor estimation. For smartphone images, we took two pictures with different orientations per point and used two processing protocols: (i) we estimated and averaged total canopy gap from the two single pictures, and (ii) merging the two pictures together, we formed images closer to full hemispheres and estimated from them CO and Site Factors. We compared the same parameters obtained from different cameras and estimated generalized linear mixed models (GLMMs) between them. Total canopy gap estimated from the first processing protocol for smartphone pictures was on average significantly higher than CO estimated from traditional camera images, although with a consistent bias. Canopy Openness and Site Factors estimated from merged smartphone pictures of the second processing protocol were on average significantly higher than those from traditional cameras images, although with relatively little absolute differences and scatter. Smartphone HP is an acceptable alternative to HP using traditional cameras, providing similar results with a faster and cheaper methodology. Smartphone outputs can be directly used as they are for ecological studies, or converted with specific models for a better comparison to traditional cameras.

Project description:PurposeOCT has revealed many details of retinal disease that were not available with older imaging technologies. In eyes of adults older than 60 years with healthy maculas as determined by color fundus photography (CFP) and a validated grading system, we screened for pathologic features using OCT. We also tested visual function to assess potential impact of the observed pathologic features on patients.DesignCross-sectional study.ParticipantsPersons recruited from primary ophthalmology care clinics.MethodsColor fundus photographs were assessed by the 9-step Age-Related Eye Disease Study scale. OCT macular volumes of participants at step 1 on the Age-Related Eye Disease Study scale, considered healthy, were reviewed by a retina specialist masked to other participant characteristics. Participants were tested for 6 different cone- and rod-mediated visual functions.Main outcome measuresPercentage of participants with disorders detected on OCT review and visual function measures.ResultsIn 138 of 984 eyes (14%) considered healthy by CFP, pathologic features were detectable by OCT, with 8.4% having vitreomacular interface disorders. Among the low-prevalence disorders found, 5 eyes (0.5%) showed macular telangiectasia type 2. Relative to eyes lacking detectable chorioretinal pathologic features, eyes with any pathologic features were associated with poorer low-luminance visual acuity and rod-mediated dark adaptation. In eyes with epiretinal membranes, the largest single entity identified (n = 61 [6.2%]), significantly worse visual functions were best-corrected visual acuity (P = 0.0444), low-luminance visual acuity (P = 0.0151), and light sensitivity (central 3° and 9°; P = 0.0035 and P = 0.0097, respectively).ConclusionsMacular pathologic features with functional visual implications not identified by clinical examination or CFP are detectable with OCT. Vitreomacular interface disorders often are visually significant and treatable conditions that are visible on OCT, but are easily missed on CFP and clinical examination. Another such condition best seen on OCT is macular telangiectasia type 2, an untreatable disorder for which a clinical trial is in progress. OCT has a potential role in primary eye care clinics to screen for retinal pathologic features, especially in eyes with decreased visual acuity and otherwise normal examination results.

Dataset Information

Smartphone-Based, Rapid, Wide-Field Fundus Photography for Diagnosis of Pediatric Retinal Diseases.

Publications

Smartphone-Based, Rapid, Wide-Field Fundus Photography for Diagnosis of Pediatric Retinal Diseases.

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