Purpose
Smartphone photography has become increasingly popular and has several applications. We retrospectively reviewed and compared standard color photographs with the negative photographic image of several retinal findings photographed with a handheld smartphone to identify any utility in the use of negative retinal images with smartphone photography.
Methods
Using an iPhone 4S (Apple Inc., Cupertino, CA, USA) and a handheld 20 or 28 diopter lens to capture retinal images of 4 separate patients with a variety of retinal conditions seen by a single resident at a metropolitan based, residency program, color photographs were compared to the negative images. The negative images were created with the application Negative Me (Fuen Mao © 2010-2013 1 stfancy Studio). The negative images were compared retrospectively to their color counterparts. Photographs were cropped to remove patient identifying information. All patients signed hospital consent forms to be photographed.
Results
Smartphone negative retinal images, when compared to their color image, best highlight hypopigmented lesions (such as Cytomegalovirus (CMV) scarring), lightly colored structures on the retina such as the optic disc, and areas or retinal pigment epithelium loss. Examination of negative images taken three weeks apart of a patient with CMV retinitis may highlight areas of retinal scarring.
Conclusions
Smartphone fundoscopy has many applications. Negative images are simple to create using smartphone technology. Certain conditions, most notably those involving hypopigmentation of the retina, may benefit from the use of negative imagery. There may also be utility in evaluating cup to disc ratios with negative imaging. This study acts as a pilot study. Further study is needed to validate the utility of negative imagery and its clinical application in disease management.