Screening for vision-threatening diabetic retinopathy in South India: comparing portable non-mydriatic and standard fundus cameras and clinical exam

Sengupta, Sabyasachi; Sindal, Manavi D; Besirli, Cagri G.; Upadhyaya, Swati; Venkatesh, Rengaraj; Niziol, Leslie M.; Robin, Alan L.; Woodward, Maria A.; Newman-Casey, Paula Anne

doi:10.1038/eye.2017.199

Cited by 32 publications

(32 citation statements)

References 31 publications

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“…Although the fundus images were taken with natural pupil size, SmartEye still had good performance in DR identification and grading. With the current widespread use of non-mydriatic fundus cameras [16–18], the SmartEye system may have broad application prospects.…”

Section: Discussionmentioning

confidence: 99%

The diagnostic accuracy of an intelligent and automated fundus disease image assessment system with lesion quantitative function (SmartEye) in diabetic patients

Wang

Liu

et al. 2019

BMC Ophthalmol

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Background With the diabetes mellitus (DM) prevalence increasing annually, the human grading of retinal images to evaluate DR has posed a substantial burden worldwide. SmartEye is a recently developed fundus image processing and analysis system with lesion quantification function for DR screening. It is sensitive to the lesion area and can automatically identify the lesion position and size. We reported the diabetic retinopathy (DR) grading results of SmartEye versus ophthalmologists in analyzing images captured with non-mydriatic fundus cameras in community healthcare centers, as well as DR lesion quantitative analysis results on different disease stages. Methods This is a cross-sectional study. All the fundus images were collected from the Shanghai Diabetic Eye Study in Diabetics (SDES) program from Apr 2016 to Aug 2017. 19,904 fundus images were acquired from 6013 diabetic patients. The grading results of ophthalmologists and SmartEye are compared. Lesion quantification of several images at different DR stages is also presented. Results The sensitivity for diagnosing no DR, mild NPDR (non-proliferative diabetic retinopathy), moderate NPDR, severe NPDR, PDR (proliferative diabetic retinopathy) are 86.19, 83.18, 88.64, 89.59, and 85.02%. The specificity are 63.07, 70.96, 64.16, 70.38, and 74.79%, respectively. The AUC are PDR, 0.80 (0.79, 0.81); severe NPDR, 0.80 (0.79, 0.80); moderate NPDR, 0.77 (0.76, 0.77); and mild NPDR, 0.78 (0.77, 0.79). Lesion quantification results showed that the total hemorrhage area, maximum hemorrhage area, total exudation area, and maximum exudation area increase with DR severity. Conclusions SmartEye has a high diagnostic accuracy in DR screening program using non-mydriatic fundus cameras. SmartEye quantitative analysis may be an innovative and promising method of DR diagnosis and grading.

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Section: Discussionmentioning

confidence: 99%

The diagnostic accuracy of an intelligent and automated fundus disease image assessment system with lesion quantitative function (SmartEye) in diabetic patients

Wang

Liu

et al. 2019

BMC Ophthalmol

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“…This camera has shown high sensitivity and specificity (>85%) in diagnosing DR compared with dilated fundus examination and even higher sensitivity and specificity in comparison with a 3-field view mydriatic table-top camera. 32,33…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of Teleretinal Imaging–Based Hospital Referral Compared With Universal Referral in Identifying Diabetic Retinopathy

et al. 2019

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Key Points Question Does screening for diabetic retinopathy by teleretinal imaging in physician offices in India lead to higher adherence to eye hospital referral and a greater yield of diabetic retinopathy cases compared with a strategy of referral of all eligible patients with diabetes? Findings In a cluster randomized clinical trial of 801 patients with diabetes, proportionately more patients in the teleretinal group attended the hospital eye examination and had confirmed diabetic retinopathy compared with the control group. Meaning The results suggest that, in the Indian setting, teleretinal screening is an effective approach for identifying diabetic retinopathy.

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“…Although the fundus images were taken with natural pupil size, SmartEye still had good performance in DR identification and grading. With the current widespread use of nonmydriatic fundus cameras [16][17][18] , the SmartEye system may have broad application prospects.…”

Section: Discussionmentioning

confidence: 99%

The Diagnostic Accuracy of an Intelligent and Automated Fundus Disease Image Assessment System with Lesion Quantitative Function (SmartEye) in Diabetic Patients

WANG

Liu

et al. 2019

Preprint

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Background With the diabetes mellitus (DM) prevalence increasing annually, the human grading of retinal images to evaluate DR has posed a substantial burden worldwide. SmartEye is a recently developed fundus image processing and analysis system with lesion quantification function for DR screening. It is sensitive to the lesion area and can automatically identify the lesion position and size. We reported the diabetic retinopathy (DR) grading results of SmartEye versus ophthalmologists in analyzing images captured with non-mydriatic fundus cameras in community healthcare centers, as well as DR lesion quantitative analysis results on different disease stages. Methods This is a cross-sectional study. All the fundus images were collected from the Shanghai Diabetic Eye Study in Diabetics (SDES) program from Apr 2016 to Aug 2017. 19904 fundus images were acquired from 6013 diabetic patients. The grading results of ophthalmologists and SmartEye are compared. Lesion quantification of several images at different DR stages is also presented. Results The sensitivity for diagnosing no DR, mild NPDR (non-proliferative diabetic retinopathy), moderate NPDR, severe NPDR, PDR (proliferative diabetic retinopathy) are 86.19%, 83.18%, 88.64%, 89.59%, and 85.02%. The specificity are 63.07%, 70.96%, 64.16%, 70.38%, and 74.79%, respectively. The AUC are PDR, 0.80 (0.79, 0.81); severe NPDR, 0.80 (0.79, 0.80); moderate NPDR, 0.77 (0.76, 0.77); and mild NPDR, 0.78 (0.77, 0.79). Lesion quantification results showed that the total hemorrhage area, maximum hemorrhage area, total exudation area, and maximum exudation area increase with DR severity. Conclusions SmartEye has a high diagnostic accuracy in DR screening program using non-mydriatic fundus cameras. SmartEye quantitative analysis may be an innovative and promising method of DR diagnosis and grading.

show abstract

Screening for vision-threatening diabetic retinopathy in South India: comparing portable non-mydriatic and standard fundus cameras and clinical exam

Cited by 32 publications

References 31 publications

The diagnostic accuracy of an intelligent and automated fundus disease image assessment system with lesion quantitative function (SmartEye) in diabetic patients

The diagnostic accuracy of an intelligent and automated fundus disease image assessment system with lesion quantitative function (SmartEye) in diabetic patients

Effectiveness of Teleretinal Imaging–Based Hospital Referral Compared With Universal Referral in Identifying Diabetic Retinopathy

The Diagnostic Accuracy of an Intelligent and Automated Fundus Disease Image Assessment System with Lesion Quantitative Function (SmartEye) in Diabetic Patients

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