September 2016
Volume 57, Issue 12
Open Access
ARVO Annual Meeting Abstract  |   September 2016
Suitability of a low-cost, handheld, non-mydriatic retinograph for diabetic retinopathy diagnosis
Author Affiliations & Notes
  • Beatrice COCHENER
    Ophtalmologie , University Hospital CHU MORVAN, Brest, France
  • Footnotes
    Commercial Relationships   Beatrice COCHENER, None
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Investigative Ophthalmology & Visual Science September 2016, Vol.57, 6319. doi:
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      Beatrice COCHENER; Suitability of a low-cost, handheld, non-mydriatic retinograph for diabetic retinopathy diagnosis. Invest. Ophthalmol. Vis. Sci. 2016;57(12):6319.

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

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Purpose : To assess the suitability of a low-cost, handheld, non-mydriatic retinograph, namely the Horus DEC 200 (MiiS, Hsinchu, Taiwan), for diabetic retinopathy (DR) diagnosis. Two factors were considered: ease of image acquisition and image quality.

Methods : One operator acquired fundus photographs from 54 patients using both the Horus and the AFC-330 (Nidek, Gamagori, Japan), a more expansive, non-portable retinograph. Satisfaction surveys were filled by patients and the operator. Then, two retinologists subjectively assessed image quality and graded DR severity in one eye of each patient. Objective image quality indices were also computed.

Results : Image acquisition was twice as long using the Horus, as opposed to the AFC-330 (115.9 seconds per eye, as opposed to 54.4 seconds – p < 0.0001). The reasons are that patients had difficulty finding the fixation target and that several acquisitions were needed before getting good enough images. Images obtained by the Horus were of significantly lower quality according to the experts (p = 0.0002 and p = 0.0004) and to the objective criterion (p < 0.0001). As a result, up to 20.4% of eyes were uninterpretable, as opposed to 9.3% using the AFC-330. However, no significant difference was found in terms of DR severity according to both experts (p = 0.557 and p = 0.156).

Conclusions : The low-cost, handheld retinograph may be used to screen DR, for instance in primary care centers or in mobile imaging units, but at the cost of longer examination times and of higher proportions of patients referred to an ophthalmologist due to inadequate image quality.

This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.


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