Current and Next Generation Portable Screening Devices for Diabetic Retinopathy

Abstract

Diabetic retinopathy (DR) is the leading cause of legal blindness in the United States, and with the growing epidemic of diabetes, a global increase in the incidence of DR is inevitable, so it is of utmost importance to identify the most costeffective tools for DR screening. Emerging technology may provide advancements to offset the burden of care, simplify the process, and provide financially responsible methods to safely and effectively optimize care for patients with diabetes mellitus (DM). We review here currently available technology, both in production and under development, for DR screening. Preliminary results of smartphone-based devices, "all-in-one" devices, and alternative technologies are encouraging, but are largely pending verification of utility when used by nonophthalmic personnel. Further research comparing these devices to current nonportable telemedicine strategies and clinical fundus examination is necessary to validate these techniques and to potentially overcome the poor compliance around the globe of current strategies for DR screening.

Detection of retinal abnormalities using smartphone-captured fundus images: a survey

“…The same objective is targeted in the work described in [25] that compares the "fundus on phone' (FOP) and 7-standard field digital retinal photography to detect DR severity. Even the poor quality in some fundus images captured by FOP images, this study does not report a signification difference on the detection performance where the correspondence metric «Kappa » between both evaluations is equal to 90%.The work described in [27] evaluates the capability of the D-Eye device to allow detecting the DR. The authors report that fundus image quality is not enough higher to detection the DR, but indicates that the technological advances will improve the Smartphone fundus photography capabilities.…”

“…Moreover, the autofocus and the zooming option facilitate the acquisition and lead to provide a fundus image good quality [25]. With data capability, connectivity and portability, the capture devices represent promising tools for screening fundus images and diagnosing ocular diseases, which can be employed for tele-ophtalmology [21,22,25,27]. The captured images and videos may be sent to ophthalmologists to be saved and interpreted.…”

“…The captured images and videos may be sent to ophthalmologists to be saved and interpreted. Such system is more and more required due to the rise of several prevalence of ocular diseases [21,27], where annual ophthalmic examinations may increase from 50% to 70% in diabetic patients [21]. Therefore, the tele-ophtalmolgy leads to bring the early diagnosis and hence rising the global visual health with respect to the aim of VISION 2020 ("VISION 2020 [21] is a global initiative of the International Agency for the Prevention of Blindness (IAPB)", https://www.aao.org/vision-2020).…”

A smartphone-based tool for rapid, portable, and automated wide-field retinal imaging

“…There has been substantial effort in recent years to incorporate smartphone-based devices in screening and monitoring of diseases such as glaucoma and diabetic retinopathy (DR) [13][14][15] While these results are encouraging, the prior literature has not addressed whether handheld retinal photography could be made simple and intuitive for non-expert operators in non-ideal settings. Indeed, experience with our first generation Ocular CellScope prototype demonstrated that smartphone imaging of the retina, while highly possible, could also be highly variable.…”

“…There is particularly great interest in the validation and integration of smartphone-based retinal photography in local community screening programs for diseases such as glaucoma and diabetic retinopathy (DR) [13][14][15][16] , as well as in the emergency department and inpatient settings where the fundus examination is under-performed [17][18][19] . DR is the most common microvascular complication of diabetes and the leading cause of vision loss in working-age adults aged 20 to 74 in the United States, accounting for 12% of new cases annually [20][21][22][23] .…”