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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)
Establish quality of smartphone ophthalmoscopy (SO) fundus images obtained by inexperienced medical students and compare them to an ophthalmology resident familiar with SO.
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.
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.
SO can produce high quality fundus images but is difficult to master, potentially limiting its utility for non-ophthalmologists.
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