Purpose Widefield imaging can detect signs of retinal pathology extending beyond the posterior pole and is currently moving to the forefront of posterior segment imaging. We report a novel, smartphone-based, telemedicine-enabled, mydriatic, widefield retinal imaging device with autofocus and autocapture capabilities to be used by non-specialist operators. Methods The Remidio Vistaro uses an annular illumination design without cross-polarizers to eliminate Purkinje reflexes. The measured resolution using the US Air Force target test was 64 line pairs (lp)/mm in the center, 57 lp/mm in the middle, and 45 lp/mm in the periphery of a single-shot retinal image. An autocapture algorithm was developed to capture images automatically upon reaching the correct working distance. The field of view (FOV) was validated using both model and real eyes. A pilot study was conducted to objectively assess image quality. The FOVs of montaged images from the Vistaro were compared with regulatory-approved widefield and ultra-widefield devices. Results The FOV of the Vistaro was found to be approximately 65° in one shot. Automatic image capture was achieved in 80% of patient examinations within an average of 10 to 15 seconds. Consensus grading of image quality among three graders showed that 91.6% of the images were clinically useful. A two-field montage on the Vistaro was shown to exceed the cumulative FOV of a seven-field Early Treatment Diabetic Retinopathy Study image. Conclusions A novel, smartphone-based, portable, mydriatic, widefield imaging device can view the retina beyond the posterior pole with a FOV of 65° in one shot. Translational Relevance Smartphone-based widefield imaging can be widely used to screen for retinal pathologies beyond the posterior pole.
Telemedicine-enabled, portable digital slit lamps can help to decentralize screening to close-to-patient contexts. We report a novel design for a portable, digital slit lamp using a smartphone. It works on an advanced optical design and has the capability of instantaneous, objective photodocumentation to capture anterior segment images and is telemedicine-enabled. Methods:The device is constructed keeping its usability and the importance of design ergonomics for nonspecialized field personnel in mind. The optical design is described, and the resolution and magnification are compared with traditional desktop-based slit lamps. A Health Insurance Portability and Accountability Act (HIPAA)-compliant, patient management software is integrated to synchronize the captured images with a secure cloud server along with a sharpness algorithm to extract the best focused frames of the cornea, iris, and lens, from videos. We demonstrate its photodocumentation ability and teleophthalmology feasibility by capturing images in a pilot study from nine subjects.Results: Images were obtained in various illumination, magnification, and filter settings. Synchronous and asynchronous teleophthalmology consults were conducted. The performance of the device was shown to be limited by the smartphone sensor resolution and not the optical design, because the Air Force target resolution was found to be the same on smartphone-mounted traditional slit lamps despite a lower magnification. Conclusions:The novel, portable, digital slit lamp with advanced optical design using smartphones has the ability to screen for anterior segment pathologies using telemedicine.Translational Relevance: A portable, telemedicine-friendly, ergonomically designed, slit lamp used by nonspecialist personnel allows for both synchronous and asynchronous modes of consultation at remote locations, facilitating mass screening programs.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.