A novel tool for the retinopathy of prematurity evaluation, associated with a digital indirect ophthalmoscope hands-free device (DIO-HF)

Abstract

Purpose : The digital indirect ophthalmoscope is a headband-mounted device to be used with smartphones, developed to performing indirect hands-free technique for Retinopathy of Prematurity (ROP) diagnosis and follow-up.
The purpose of this work is to describe and evaluate the efficiency of a scleral rotator led plus fiber-optic transillumination system, for the ocular fundus evaluation.

Methods :

An experimental study was performed to evaluate a prototype, developed with a LED source connected to a 1 mm plastic fiber optic. It is linked to an oval round shape extreme of a scleral depressor similar to “lens ansa”, to delivery the cold light at the other side. (Figure 1)
To evaluate the function of the prototype, under general anesthesia, 2 dogs fundoscopy was performed, after a lid speculum was placed. Firstly only with the DIO-HF with smartphone set in flash mode “ON” (group A) and then with the aid of the illumination prototype (group B). Pictures and video frames were taken for both procedures. In the experimental set-up, both eyes were carefully explored. After that, images were processed to be subjectively analyzed.
The subjective evaluation was realized to obtain the opinion of 10 ophthalmologists specialized in ROP, to know which ones of them they will prefer. Groups A and B have been masked and ophthalmologist has asked three possible options about their preference: 1- Group A; 2- Group B or 3: There is no difference between both groups. All of the pictures and frame videos were taken for only one ophthalmologist.

Results : Images and videos from both groups let to perform a good exploratory exam.
The quality of the images and videos obtained in group B have ba etter aspect, less light artifacts.
The subjective evaluation shows that all the ophthalmologists have preferred group B.

Conclusions : This new prototype seems to be useful to improve the quality image obtained with the DIO-HF, with potential usefulness in smartphone telemedicine networks for ROP, and ROP training.

This abstract was presented at the 2019 ARVO Imaging in the Eye Conference, held in Vancouver, Canada, April 26-27, 2019.