Nonmydriatic Fundus Camera for Diabetic Retinopathy Screening in a Safety Net Hospital: Effectiveness, Prevalence, and Risk Factors

Schwartz, Shulamit; Harasawa, Mariana; Baldivieso, Valeria; Sabel, Allison L.; Mandava, Naresh; Quiroz‐Mercado, Hugo

doi:10.5301/ejo.5000515

Cited by 8 publications

(4 citation statements)

References 30 publications

(34 reference statements)

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“…[13, 14] Without pharmacologic dilation, the fundus image quality of current cameras was significantly affected by the pupil size, especially when the pupils were constricted below 3.5 mm. A recent study by Schwartz et al indicated that non-mydriatic fundus camera is an effective and feasible screening tool for the early detection of DR. [15] The non-mydriatic color fundus photography and telemedicine succeeded in screening for AMD in their study. Similarly, another study in France showed consistent results for successful AMD screening with a non-mydriatic color fundus photography and telemedicine.…”

Section: Discussionmentioning

confidence: 99%

Telemedicine screening of retinal diseases with a handheld portable non-mydriatic fundus camera

Jin

et al. 2017

BMC Ophthalmol

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BackgroundWe modified and reconstructed a high image quality portable non-mydriatic fundus camera and compared it with the tabletop fundus camera to evaluate the efficacy of the new camera in detecting retinal diseases.MethodsWe designed and built a novel portable handheld fundus camera with telemedicine system. The image quality of fundus cameras was compared to that of existing commercial tabletop cameras by taking photographs of 364 eyes from the 254 patients. In all 800 fundus images taken by two camera types, 400 images per camera, were graded with the four image clarity classifications.ResultsUsing the portable fundus camera, 63% (252/400) images were graded as excellent overall quality, 20.5% (82/400) were good, 11.75% (47/400) were fair, and 4.75% (19/400) were inadequate. Using the tabletop fundus camera, 70.75% (283/400) images were graded as excellent overall quality, 20.4% (51/400) were good, 13.25% (53/400) were fair, and 3.25% (13/400) were inadequate. Common retinal diseases were easily identified from fundus images obtained from the portable fundus camera.ConclusionThe new type of non-mydriatic portable fundus camera was qualified to have professional quality of fundus images. The revolutionary screening camera provides a foundational platform which can potentially improve the accessibility of retinal screening programmes.

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Section: Discussionmentioning

confidence: 99%

Telemedicine screening of retinal diseases with a handheld portable non-mydriatic fundus camera

Jin

et al. 2017

BMC Ophthalmol

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“…Patients were diagnosed with DR in accordance with the Early Treatment Diabetic Retinopathy Study guidelines: DR was defined as the presence of at least one retinal microaneurysm or blot hemorrhage with or without additional lesions such as exudates (hard or soft), intraretinal microvascular abnormalities, venous beading, neovascularization (disc or elsewhere), and vitreous hemorrhage. 12 Patients with any unreadable photograph in at least one eye underwent direct examination by an ophthalmologist to determine their DR status.…”

Section: Methodsmentioning

confidence: 99%

Associations of serum uric acid level with diabetic retinopathy and albuminuria in patients with type 2 diabetes mellitus

et al. 2020

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Objectives To analyze the associations of serum uric acid (SUA) level with diabetic microvascular complications, including diabetic retinopathy (DR) and diabetic nephropathy (DN), in patients with type 2 diabetes mellitus (DM). Methods Three hundred eighty-nine inpatients with type 2 DM were included in this retrospective analysis. Nonmydriatic fundus cameras were used to identify DR. Urinary albumin creatinine ratio was used to identify DN. Patients were divided into four groups according to SUA quartiles. Results The prevalences of DR and albuminuria increased with increasing SUA level. Multivariate logistic regression analysis showed that, following adjustment for other risk factors, higher levels of SUA (Q3 and Q4) were associated with greater risk for DR, compared with the lower level (Q1) (odds ratio [OR]: 3.056, 95% confidence interval [CI]: 1.506–6.198; OR: 3.417, 95% CI: 1.635–7.139, respectively). Moreover, higher levels of SUA (Q2, Q3, and Q4) were associated with greater risk for albuminuria (OR: 2.418, 95% CI: 1.059–5.522; OR: 7.233, 95% CI: 3.145–16.635; and OR: 8.911, 95% CI: 3.755–21.147, respectively). Conclusions SUA level was independently associated with DR and albuminuria in patients with type 2 DM. Elevated SUA level might be predictive for the occurrence of DR and DN.

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“…In addition to scanning laser ophthalmoscopy 8 and optical coherence tomography, 5 non-mydriatic photography systems are used in telemedicine and screening programs. Therefore, evaluations of usability have been performed for several systems (eg, for diabetic retinopathy screening 9 , 10 or age-related macular degeneration screening). 11 Lamirel et al reported on important factors for increasing the quality of non-mydriatic photography operated by non-ophthalmically trained personnel in an emergency department.…”

Section: Discussionmentioning

confidence: 99%

Quality and learning curve of handheld versus stand-alone non-mydriatic cameras

Gosheva¹,

Klameth²,

Norrenberg³

et al. 2017

OPTH

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PurposeNowadays, complex digital imaging systems allow detailed retinal imaging without dilating patients’ pupils. These so-called non-mydriatic cameras have advantages in common circumstances (eg, for screening or emergency purposes) but present limitations in terms of image quality and field of view. We compare the usefulness of two non-mydriatic camera systems (ie, a handheld versus a stand-alone device) for fundus imaging. The primary outcome was image quality. The secondary outcomes were learning effects and quality grade-influencing factors.MethodsThe imaging procedures followed standard protocol and were all performed by the same investigator. Camera 1 (DRS®) was a stand-alone system, while Camera 2 (Smartscope® PRO) was a mobile system. In order to evaluate possible learning effects, we selected an examiner with no prior training in the use of these systems. The images were graded separately by two experienced and “blinded” ophthalmologists following a defined protocol.ResultsIn total, 211 people were enrolled. Quality grade comparisons showed significantly better grades for Camera 1. Both systems achieved better quality grades for macular images than for disc-centered images. No remarkable learning effects could be demonstrated.ConclusionsBoth camera systems are useful for fundus imaging. The greater mobility of Camera 2 was associated with lower image quality. For screening scenarios or telemedicine, it must be determined whether image quality or mobility is more important.

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Nonmydriatic Fundus Camera for Diabetic Retinopathy Screening in a Safety Net Hospital: Effectiveness, Prevalence, and Risk Factors

Abstract: Nonmydriatic fundus camera is an effective and feasible screening tool for the early detection of DR in a safety net institution. It should be considered in areas with limited access to health care to improve quality of care and potentially reduce vision loss rates.

Cited by 8 publications

References 30 publications

Telemedicine screening of retinal diseases with a handheld portable non-mydriatic fundus camera

Telemedicine screening of retinal diseases with a handheld portable non-mydriatic fundus camera

Associations of serum uric acid level with diabetic retinopathy and albuminuria in patients with type 2 diabetes mellitus

Quality and learning curve of handheld versus stand-alone non-mydriatic cameras

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