Evaluation of Nuclear Cataract with Smartphone-Attachable Slit-Lamp Device

Abstract

Background: Visual impairments and age-related eye diseases need to be detected and treated in a timely manner. However, this is often hampered by lack of appropriate medical equipment. We have invented a portable, recordable, and smartphone-attachable slit-lamp device, called the Smart Eye Camera (SEC). The aim of this study was to compare evaluating nuclear cataract (NUC) between the SEC and the conventional, non-portable slit-lamp microscope. Methods: A total of 128 eyes of 64 Japanese patients (mean age: 73.95 ± 9.28 years; range: 51‒92 years; female: 34) were enrolled. The NUC was classified into four grades (grade 0 to 3) based on three standard photographs of nuclear opacities according to the WHO classification by ophthalmologists. An ophthalmic healthcare assistant (non-ophthalmologist) filmed the eyes in video mode by the SEC and an ophthalmologist graded the NUC. Grade correlation and inter-rater reproducibility were determined. Results: NUC grading by the two approaches correlated significantly (both eyes: r = 0.871 [95%CI: 0.821 to 0.907; p < 0.001]). Inter-rater agreement was high (weighted κ = 0.807 [95%CI: 0.798 to 0.816; p < 0.001]). Conclusions: This study suggests that the SEC is as reliable as the conventional non-portable slit-lamp microscope for evaluating NUC.

A Study Validating the Estimation of Anterior Chamber Depth and Iridocorneal Angle with Portable and Non-Portable Slit-Lamp Microscopy

“…The SEC has a function that converts the light source from the smartphone into a 1-mm thin beam, allowing it to fall on the crystalline lens. Moreover, the SEC has a convex lens that magnifies the reflected light to a degree sufficient for ocular diagnosis [ 5 , 15 , 16 ]. The iPhone 7, 8, or SE (Apple Inc., Cupertino, CA, USA) was used to record the ocular video.…”

“…Therefore, patients are required to visit the medical center for ophthalmologic examinations. Although some types of portable slit-lamp microscopes exist, these instruments lack a recording function [ 5 ]. Moreover, these instruments are basically disconnected from the internet to safeguard patients’ medical information.…”

“…Moreover, these instruments are basically disconnected from the internet to safeguard patients’ medical information. Some smartphone-based slit-lamp devices have already been developed, but these devices have not yet become common [ 5 ]. The recently developed state-of-the-art anterior-segment optical coherence tomography (AS-OCT) enables one to provide the optic pathology in real time using low-coherence interferometry [ 6 , 7 ].…”

“…Enabled to quantitatively measure various anterior chamber parameters as corneal curvature radius, corneal thickness, corneal higher-order aberrations, and trabecular-iris angle (TIA) [ 9 , 10 , 11 , 12 , 13 , 14 ]. However, the AS-OCT device (which makes objective measurements) is also unmovable, similar to the portability issue associated with the conventional slit-lamp microscopes [ 5 ]. Thus, we invented a portable and recordable slit-lamp device, named the smart eye camera (SEC), to address the issues associated with immovability and recordability.…”

“…The SEC converts the light of the smartphone to the essential light needed for the ophthalmological diagnosis. We previously demonstrated its diagnostic function for cataracts in humans and the dry eye disease mouse model [ 5 , 15 , 16 ]. However, no study has investigated the ACD evaluation and angle estimation function of the portable and recordable slit-lamp device.…”