A Systematic Review of Digital Ophthalmoscopes in Medicine

Abstract

Purpose Recent advances in telemedicine have led to increased use of digital ophthalmoscopes (DO) in clinical settings. This review aims to assess commercially available DOs, including smartphone (SP), desktop, and handheld ophthalmoscopes, and evaluate their applications. Methods A literature review was performed by searching PubMed (pubmed.ncbi.nlm.nih.gov), Web of Science (webofknowledge.com), and Science Direct (sciencedirect.com). All English-language papers that resulted from the search terms “digital ophthalmoscope”, “screening tool”, “glaucoma screening”, “diabetic retinopathy screening”, “cataract screening”, and “papilledema screening” were reviewed. Studies that contained randomized clinical trials with human participants between January 2010 and December 2020 were included. The Risk of Bias in Systematic Reviews (ROBIS) tool was used to assess the methodological quality of each included paper. Results Of the 1307 studies identified, 35 met inclusion and exclusion criteria. The ROBIS tool determined that 29/35 studies (82.8%) had a low risk of bias, 3/35 (8.5%) had a moderate risk of bias, and 3/35 (8.5%) had a high risk of bias. Conclusion The continued adoption of DOs remains uncertain because of concerns about the image quality for non-mydriatic eyes and the confidence in data captured from the device. Likewise, there is a lack of guidelines for the use of DOs, which makes it difficult for providers to determine the best device for their practice and to ensure appropriate use. Even so, DOs continue to gain acceptance as technology and practice integration improve, especially in underserved areas with limited access to ophthalmologists.

Advances and Perspectives in Relation to the Molecular Basis of Diabetic Retinopathy—A Review

“…Nevertheless, there are no international guidelines concerning DO usage, but the inclusion of those techniques should be considered [9]. There are different DOs, desktop-based DOs, handheld DOs, and smartphone-based retinal imaging DOs, and their sensitivity ranged from 61% to 81% between different studies considered in the most recent systematic review [10]. However, the NO BLIND study showed 100% specificity and 94.3% sensitivity for digital ophthalmoscope usage by ophthalmology specialists as compared to standard fundus oculi examination in mydriasis [11].…”