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Tapan P Patel, Tyson Kim, Gina Yu, Vaidehi S Dedania, Philip Lieu, Cagri G Besirli, Hakan Demirci, Yannis Mantas Paulus; Smartphone-based wide-field fundus photography for accurate diagnosis of pediatric retinal diseases. Invest. Ophthalmol. Vis. Sci. 2018;59(9):4621. doi: https://doi.org/.
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In many resource-challenged communities, there is an unmet need for cost-effective, portable, reliable, and easy-to-use, retinal photography to aid in the screening and diagnosis of posterior segment eye diseases to help prevent blindness. Smartphone-based fundus photography offers an elegant solution. While this technology is rapidly evolving in adults, it has lagged behind in the pediatric patient population. This study presents a feasibility analysis of a novel smartphone-based retinal imaging device tailored to pediatric retinal care.
Our existing RetinaScope device, utilizing the smartphone’s camera, Bluetooth connectivity, and processing power to perform 100-degree montaging, was modified for use in a pediatric setting. This included a child-friendly 3D printed housing of animals, attention grabbing targets, enhanced image stitching and video-recording capability to capture continuous clips of the fundus exam. Fundus photographs were acquired in a pediatric outpatient clinic, inpatient bedside, emergency room, and during exam under anesthesia. The ease of image acquisition and comfort of the patient were assessed via a validated 5-point survey. Time for image acquisition per eye was also recorded. A subset of the images was graded by two independent, masked, expert graders and the accuracy of the grader to clinician diagnosis was compared. The study was approved by the University of Michigan Institutional Review Board Committee and has ClinicalTrials.gov Identifier NCT03076697.
Fundus photographs were acquired in 62 eyes of 42 patients. Mean age of the cohort was 6.7 years (range 6 weeks to 18 years). Average time to acquire a standard 5 field photograph of each eye was 2.3 min ± 1.1 min. Patients rated their overall experience of image acquisition favorably, average Likert score 4.6 ± 0.8. The diagnoses included: Coats disease, retinoblastoma, retinopathy of prematurity, commotio retinae, coloboma, ocular albinism, and optic nerve hypoplasia, among others. A sub-set of images was graded by two masked vitreoretinal specialists. There was 93% agreement between image-based diagnosis and the treating clinician’s diagnosis.
We report a novel smartphone-based device for wide-field fundus photography in pediatric patients. Our device is able to rapidly acquire diagnostic quality images of the retina without causing undue distress to the patients.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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