April 2014
Volume 55, Issue 13
Free
ARVO Annual Meeting Abstract  |   April 2014
Quality of Mydriatic Fundus Smartphone Photography: Preliminary Results from the Smartphone Ophthalmoscopy Reliability Trial (SORT)
Author Affiliations & Notes
  • Murtaza Khuzema Adam
    Retina Service, Wills Eye Hospital at Thomas Jefferson University, Philadelphia, PA
  • Christopher J Brady
    Retina Service, Wills Eye Hospital at Thomas Jefferson University, Philadelphia, PA
  • Alexis M Flowers
    Retina Service, Wills Eye Hospital at Thomas Jefferson University, Philadelphia, PA
  • Alexander Juhn
    Retina Service, Wills Eye Hospital at Thomas Jefferson University, Philadelphia, PA
  • Jason Hsu
    Retina Service, Wills Eye Hospital at Thomas Jefferson University, Philadelphia, PA
  • Sunir Garg
    Retina Service, Wills Eye Hospital at Thomas Jefferson University, Philadelphia, PA
  • Ann P Murchison
    Research, Wills Eye Hospital at Thomas Jefferson University, Philadelphia, PA
  • Marc Spirn
    Retina Service, Wills Eye Hospital at Thomas Jefferson University, Philadelphia, PA
  • Footnotes
    Commercial Relationships Murtaza Adam, None; Christopher Brady, None; Alexis Flowers, None; Alexander Juhn, None; Jason Hsu, None; Sunir Garg, None; Ann Murchison, None; Marc Spirn, None
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science April 2014, Vol.55, 1608. doi:
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      Murtaza Khuzema Adam, Christopher J Brady, Alexis M Flowers, Alexander Juhn, Jason Hsu, Sunir Garg, Ann P Murchison, Marc Spirn; Quality of Mydriatic Fundus Smartphone Photography: Preliminary Results from the Smartphone Ophthalmoscopy Reliability Trial (SORT). Invest. Ophthalmol. Vis. Sci. 2014;55(13):1608.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose: Establish quality of smartphone ophthalmoscopy (SO) fundus images obtained by inexperienced medical students and compare them to an ophthalmology resident familiar with SO.

Methods: 79 consecutive patients evaluated in the Wills Eye Emergency Department for a variety of visual and ocular complaints were enrolled into one of three study arms: medical student 1 (MS1), medical student 2 (MS2), and ophthalmology resident (OR). Acquired SO images (158 eyes) were graded for overall quality by a masked reviewer using an established quantitative fundus photo grading system. Four anatomic regions were independently evaluated for quality: optic nerve, macula, superior, and inferior vascular arcades. Observed critical fundus findings on SO fundus images were compared to emergency department dilated fundus exam documentation.

Results: OR images were significantly higher quality than MS1 and MS2 images (p<0.017, Mann-Whitney U with Bonferroni correction). Image quality trended toward improvement over time in all groups, but not significantly (all p>0.062, two-tailed Pearson’s correlation coefficient). Smartphone images detected 47% of critical fundus findings in the MS1 group, 50% in the MS2 group, and 89% in the OR group. Regional quality analysis revealed the optic nerve was most frequently visualized and highest quality (p<0.001, McNemar chi-square test), while the superior arcade was least often visualized and poorest quality with SO.

Conclusions: SO can produce high quality fundus images but is difficult to master, potentially limiting its utility for non-ophthalmologists.

Keywords: 550 imaging/image analysis: clinical • 688 retina  
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