Diagnostic accuracy of handheld fundus photography: A comparative study of three commercially available cameras

Abstract

The objective of this study was to compare the sensitivity and specificity of handheld fundus cameras in detecting diabetic retinopathy (DR), diabetic macular edema (DME), and macular degeneration. Participants in the study, conducted at Maharaj Nakorn Hospital in Northern Thailand between September 2018 and May 2019, underwent an ophthalmologist examination as well as mydriatic fundus photography with three handheld fundus cameras (iNview, Peek Retina, Pictor Plus). Photographs were graded and adjudicated by masked ophthalmologists. Outcome measures included the sensitivity and specificity of each fundus camera for detecting DR, DME, and macular degeneration, relative to ophthalmologist examination. Fundus photographs of 355 eyes from 185 participants were captured with each of the three retinal cameras. Of the 355 eyes, 102 had DR, 71 had DME, and 89 had macular degeneration on ophthalmologist examination. The Pictor Plus was the most sensitive camera for each of the diseases (73–77%) and also achieved relatively high specificity (77–91%). The Peek Retina was the most specific (96–99%), although in part due to its low sensitivity (6–18%). The iNview had slightly lower estimates of sensitivity (55–72%) and specificity (86–90%) compared to the Pictor Plus. These findings demonstrated that the handheld cameras achieved high specificity but variable sensitivities in detecting DR, DME, and macular degeneration. The Pictor Plus, iNview, and Peek Retina would have distinct advantages and disadvantages when applied for utilization in tele-ophthalmology retinal screening programs.

Mobile Diagnostic Clinics

“…This device successfully detected brain abnormalities in 97% of patients imaged while admitted to neuroscience intensive care units. 98 The Pictor Plus Portable Ophthalmic Camera (Volk Optical Inc., Mentor, OH) has made it easier to capture highresolution images of the retina for the diagnosis of conditions like diabetic retinopathy 99 and glaucoma, 100 particularly in locations where more sophisticated equipment is unavailable (Figure 2H). 101,102 Additionally, Portable X-ray Devices, such as the HF120/60HPPWV PowerPlus (MinXray, Northbrook, IL), are now accessible to field hospitals, sports medicine, and veterinary practice, as they are highly portable, lightweight, and robust.…”

“…(b) Diagnosis of Diabetic Retinopathy by hand-held fundus camera. Reprinted (in part) with permission from Lu et al Ref . Copyright 2022 PLoS.…”

“…The Pictor Plus Portable Ophthalmic Camera (Volk Optical Inc., Mentor, OH) has made it easier to capture high-resolution images of the retina for the diagnosis of conditions like diabetic retinopathy and glaucoma, particularly in locations where more sophisticated equipment is unavailable (Figure H). , Additionally, Portable X-ray Devices, such as the HF120/60HPPWV PowerPlus (MinXray, Northbrook, IL), are now accessible to field hospitals, sports medicine, and veterinary practice, as they are highly portable, lightweight, and robust. , An AI-driven image interpretation system has also been developed to complement the device use. In a study conducted in remote populations in Nigeria, an ultraportable X-ray device was used along with the AI interpretation to screen patients for tuberculosis .…”

Artificial intelligence and hemodynamic studies in optical coherence tomography angiography for diabetic retinopathy evaluation: A review

“…These include image distortion, eyelash artifacts, low-resolution images, limited ability to view vascular and peripheral structures inside the retina, restricted imaging field of view (FOV), and the need for multiple scans across the macula to obtain appropriate images. 17 Optical coherence tomography (OCT). OCT is a noninvasive imaging method that produces high-resolution cross-sectional images of the microstructures inside the retina of the eye using low-coherent light interferometry.…”

“…These include image distortion, eyelash artifacts, low-resolution images, limited ability to view vascular and peripheral structures inside the retina, restricted imaging field of view (FOV), and the need for multiple scans across the macula to obtain appropriate images. 17…”