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Taras Litvin, Glen Ozawa, Jorge Cuadros, Matthew Muller, Ann Elsner, Thomas Gast, Jeff Clendenon, Lisa Ensman, Tuhin Roy, Danny Li; Evaluation of the Digital Light Projector Camera (DLP-Cam) for Low-Cost Diabetic Retinopathy Screening. Invest. Ophthalmol. Vis. Sci. 2013;54(15):5844.
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To provide low-cost, nonmydriatic screening for diabetic retinopathy (DR) with a novel retinal imaging system that captures sufficient retinal detail to generate referrals with high sensitivity and specificity.
The DLP-Cam is a low-cost non-mydriatic camera that obtains confocal retinal images at 17 frames per second. It obtains 33x25 degree images over a wide refractive error (±10 diopter) with low intensity red or green illumination (42 uW). The DLP-Cam uses a small 1.6mm entrance/exit pupil and is easily transported to different sites (8”x6”x3”; 2.2 lbs). To evaluate the DLP-Cam’s ability to detect DR, a study comparing cameras was performed. The Canon CR6 fundus camera, iVue OCT, and DLP-Cam were used to image adult diabetic patients at Eastmont Wellness Center, Oakland, CA. Three overlapping 45 degree images of the posterior pole were obtained with the Canon. Three matching images were obtained using the DLP-Cam. Macular map scans were performed with the iVue. An EyePACS-certified diabetic retinopathy grader compared the Canon, iVue, and DLP-Cam images side-by-side for the presence and appearance of DR.
45 diabetic patients (average age of 53 years) were enrolled. 46% were females. 44% were Latin American, 24% were African American, 23% were Asian, and 9% were Caucasian. 33% of patients had no DR, 22% had mild non-proliferative DR (NPDR), 26% had moderate NPDR, and 13% had proliferative DR. Clinically significant macular edema was diagnosed in 6%. Compared to Canon images, the DLP-Cam showed matching hard exudates and hemorrhages (Figure 1). In addition, the DLP-Cam images provided clearer visualization of optic nerve cup-to-disc boundaries and retinal nerve fiber defects, useful for the detection of glaucoma (Figure 2). The ability to acquire images separately with red-free and red illumination channels provides visualization of the superficial retina and the choroid, respectively.
Preliminary testing of DLP-Cam shows potential for the DLP-Cam to be used as a low-cost, portable retinal screening camera.
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