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Ketaki Panse, Joshua Frenkel, Sunny Manwani, Pavani Andru, Ramesh Ayyala; Smartphone-based Ophthalmic Imaging with Paxos ScopeTM for Retinopathy of Prematurity Screening in India. Invest. Ophthalmol. Vis. Sci. 2018;59(9):2747.
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© ARVO (1962-2015); The Authors (2016-present)
Paxos ScopeTM (DigiSight Technologies) is an FDA-registered Class II 510(k) exempt device for both anterior and mydriatic posterior segment photography that enables low-cost teleophthalmology through a proprietary, secure, cloud-based platform. This technology can be used with any smartphone with minimal modifications and the information is stored in a HIPAA-compliant cloud based application. Current technology used to screen for Retinopathy of Prematurity (ROP) is too expensive to be used in most parts of the world. We aim to test the applicability of screening premature babies for ROP using the Paxos technology in peripheral NICU units located in Hyderabad, India.
Retinal fellows based in Anand Eye Institute, Hyderabad, India were trained on the use of the platform to obtain anterior and posterior images of newborn babies using Paxos ScopeTM during ROP screenings. Following the screening, the photos/videos were posted on the cloud with comments about proposed management. This data was then reviewed by the retina faculty and comments posted regarding management. The quality of the photos was measured using a five-point scale as described in the FOTO-ED study. Diagnoses from photos taken were correlated to those achieved by in-person clinical exam. Correlation between the diagnosis and management proposed by the fellow and faculty agreement was calculated.
54 eyes were photo-documented at NICU hospitals, and images were then diagnosed by expert retinal faculty at Anand Eye Institute. An average of 1.96 +/- .86 comments were exchanged per image between the faculty and fellow. Mean FOTO-ED score out of 5 was 4.55 +/- .91. The fellow’s diagnosis correlated with the faculty diagnosis for 74.8% of the trials, while management was altered by faculty recommendations for 25.8% of trials.
Paxos ScopeTM provided an easy-to-use, low-cost, and high quality posterior segment imaging solution to diagnose ROP where conventional ophthalmic cameras were not available. The device provides a cost-effective solution for teleophthalmology in under-resourced settings with difficult access to subspecialty ophthalmologic care.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
Photo taken by Dr. Sunny Manwani, Retinal Fellow at Anand Eye Institute using Paxos Scope in Hyderabad, India. ROP Zone 3 Stage 2.
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