Dataset Information

Clinical Observation of Allergic Conjunctival Diseases with Portable and Recordable Slit-Lamp Device.

ABSTRACT:

Background

The incidence of allergic conjunctival diseases (ACDs) is gradually increasing worldwide. Both ophthalmologists and non-ophthalmologists prescribe eye drops to treat ACDs; however, there are many cases which are treated without sufficient examination and diagnosis of the eyes. We have invented a portable, recordable, and smartphone-attachable slit-lamp device-Smart Eye Camera (SEC). The purpose of this study was to compare the diagnostic abilities of ACDs between the SEC and the conventional, non-portable slit-lamp microscope.

Methods

This prospective observational study included 32 eyes of 17 Japanese patients (mean age: 21.5 ± 14.8 years; range: 11-51 years; female: 5). The severity of 10 objective signs in the palpebral conjunctiva, bulbar conjunctiva, limbus, and cornea were scored on a grading scale of 0 to 4 (0 = normal; 1+ = mild; 2+ = moderate; 3+ = severe), respectively. First, the conventional slit-lamp microscope was used to examine the grade of the ACDs. Second, another ophthalmologist filmed the eyes using the SEC and two other ophthalmologists evaluated the grades on another day. The correlation and inter-rater reproducibility in total scores among the two devices were determined.

Results

Total scores of clinical signs, evaluated by the two approaches, correlated significantly (both eyes: r = 0.918 (95% CI: 0.839 to 0.959; p < 0.001)), with substantial inter-rater agreement (weighted κ value = 0.631 (95% CI: 0.601 to 0.661; p < 0.001)).

Conclusions

The SEC is as reliable as the conventional non-portable slit-lamp microscope for assessing ACDs.

SUBMITTER: Yazu H

PROVIDER: S-EPMC8002473 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:PurposeTo assess the usability and image quality of a smartphone adapter for direct slit lamp imaging.MethodsA single-center, prospective, clinical study conducted in the Department of Ophthalmology at the University Hospital Zurich, Switzerland. The smartphone group consisted of 26 medical staff (consultants, residents, and students). The control group consisted of one ophthalmic photographer. Both groups took images of the anterior and the posterior eye segment of the same proband. The control group used professional photography equipment. The participant group used an Apple iPhone 11 mounted on a slit lamp via a removable SlitREC smartphone adapter (Custom Surgical GmbH, Munich, Germany). The image quality was graded independently by two blinded ophthalmologists on a scale from 0 (low) to 10 (high quality). Images with a score ≥ 7.0/10 were considered as good as the reference images. The acquisition time was measured. A questionnaire on usability and experience in smartphone and slit lamp use was taken by all of the participants.ResultsEach participant had three attempts at the same task. The overall smartphone quality was 7.2/10 for the anterior and 6.4/10 for the posterior segment. The subjectively perceived difficulty decreased significantly over the course of three attempts (Kendall's W). Image quality increased as well but did not improve significantly from take 1 to take 3. However, the image quality of the posterior segment was significantly, positively correlated (Spearman's Rho) with work experience. The mean acquisition time for anterior segment imaging was faster in the smartphone group compared to the control group (156 vs. 206 s). It was vice versa for the posterior segment (180 vs. 151 s).ConclusionSlit lamp imaging with the presented smartphone adapter provides high-quality imaging of the anterior segment. Posterior segment imaging remains challenging in terms of image quality. The adapter constitutes a cost-effective, portable, easy-to-use solution for recording ophthalmic photos and videos. It can facilitate clinical documentation and communication among colleagues and with the patient especially outside normal consultation hours. Direct slit lamp imaging allows for time to be saved and increases the independence of ophthalmologists in terms of patient mobility and the availability of photographic staff.