Comparison of a Smartphone-Based Photography Method with Indirect Ophthalmoscopic Assessment in Referable Retinopathy of Prematurity

Sharma, Ashish; Goyal, Anubhav; Bilong, Yannick; Shah, Parag K; Banker, Alay; Kumar, Nilesh; Sharma, Rohini; Kuppermann, Baruch D.; Bandello, Francesco

doi:10.1016/j.oret.2019.06.006

Cited by 19 publications

(10 citation statements)

References 4 publications

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“…The major difference is of the use of holding device for smart phone and lens in Sharma's study. 19 Our study adds to the growing evidence that smart phone-based imaging for ROP screening and detection is proving its utility. Although, the field of view captured by smart phone is only 30 degrees as compared to 130 degrees of RetCam, the information gathered through smart phone was significant and vital for accurate diagnosis.…”

Section: Discussionmentioning

confidence: 68%

Smartphone-based fundus imaging for evaluation of Retinopathy of Prematurity in a low-income country: A pilot study

Choudhary¹,

Hashmi²,

Tayyab³

2023

Pak J Med Sci

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Objectives: To evaluate the feasibility of a novel and simple smart phone-based Retinopathy of Prematurity (ROP) screening approach in a resource-constrained setting. Methods: This cross-sectional validation study was conducted at the Department of Ophthalmology and Neonatal Intensive Care Unit (NICU) of The Aga Khan University Hospital, Pakistan, from January 2022 to April 2022. A total of 63 images of eyes with active ROP (stage-1, 2, 3, 4 and/or plus or pre-plus disease) were included in this study. The stage of ROP was documented by the principal investigator using an indirect ophthalmoscope and retinal images were obtained using this novel technique. These images were shared with two masked ROP experts who rated the image quality and determined the stage of ROP and presence of plus disease. Their reports were compared with the initial findings reported by principal investigator using indirect ophthalmoscope. Results: We reviewed 63 images for image quality, stage of ROP and presence of plus disease. There was significant agreement between the gold standard and the Rater-1 and 2 for the presence of plus disease (Cohen’s kappa was 0.84 and 1.0) and the stage of the disease (Cohen’s kappa 0.65 and 1.0). There was significant agreement between the Rater for presence of plus disease and any stage of ROP (Cohen’s κ: 0.84 and 0.65 for plus disease and any stage of the ROP, respectively). Rater-1 and 2 rated 96.83% and 98.41% images as excellent / acceptable respectively. Conclusions: High quality retinal images can be captured with a smartphone and 28D lens without using any additional adapter equipment. This approach of ROP screening can form basis of telemedicine for ROP in resource constrained areas. doi: https://doi.org/10.12669/pjms.39.3.7053 How to cite this: Choudhary RA, Hashmi S, Tayyab H. Smartphone-based fundus imaging for evaluation of Retinopathy of Prematurity in a low-income country: A pilot study. Pak J Med Sci. 2023;39(3):638-643. doi: https://doi.org/10.12669/pjms.39.3.7053 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Section: Discussionmentioning

confidence: 68%

Smartphone-based fundus imaging for evaluation of Retinopathy of Prematurity in a low-income country: A pilot study

Choudhary¹,

Hashmi²,

Tayyab³

2023

Pak J Med Sci

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“…Limitations of smartphone-based adapters include longer examination times and a smaller field of view (56°) compared to contact-based systems [76]. Similarly, other low-cost smartphone adapters such as the RetinaScope and MII Ret Cam have been validated for ROP screening as well [77,78].…”

Section: Novel Imaging For Ropmentioning

confidence: 99%

Current Management of Retinopathy of Prematurity

Tsai

Acaba-Berrocal

Sobhy

et al. 2022

Curr Treat Options Peds

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Purpose of Review This review aims to provide an update on the recent major advances in the management of retinopathy of prematurity (ROP). Recent Findings There have been a number of major advances in our understanding and management of ROP over the last decade: (1) The advent of improved imaging techniques and technological infrastructure has led to the increased use of telemedicine and potential use of artificial intelligence to enhance access to care for children at risk of developing ROP; (2) the International Classification of Retinopathy of Prematurity (ICROP) 3rd edition has provided updates in classification of ROP and response of ROP to treatment; and (3) the treatment paradigm has shifted from laser therapy exclusively to now having the option of anti-vascular endothelial growth factor (VEGF) therapy. This has led to greater interest in trying to better understand the possible adverse events related to systemic and local VEGF suppression. Summary There is a greater understanding in the diagnosis and treatment of ROP and its response to treatment. The advent of anti-VEGF therapy has provided ROP providers with a treatment modality that may lead to improved visual outcomes without the need for peripheral retinal ablation. However, there remain questions regarding systemic and local adverse events. Laser photocoagulation continues to be an effective primary therapy and may also be needed after or in conjunction with anti-VEGF treatment.

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“…This also minimises any risk of infection, as it does not involve any imaging probes. We have published a similar pilot model in the recent past [ 10 ]. Furthermore, it also allows for the imaging to be carried out in lower light exposure when compared with an indirect ophthalmoscope [ 11 ].…”

Section: Opportunities Of the S-rop Imagingmentioning

confidence: 99%