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Updated: Jan 1, 2026
Smartphone Fundus Photography
Published on: July 6, 2017
Non-contact smartphone-based fundus imaging compared to conventional fundus imaging: a low-cost alternative for
Maximilian W M Wintergerst1, Michael Petrak1, Jeany Q Li1
1Department of Ophthalmology, University of Bonn, Ernst-Abbe-Str. 2, 53127, Bonn, Germany.
Insights
Smartphone-based fundus imaging (SBFI) offers an affordable, mobile alternative for retinopathy of prematurity (ROP) screening. This low-cost method shows potential for improving ROP care in underserved regions.
Area of Science:
- Ophthalmology
- Medical Technology
- Public Health
Background:
- Retinopathy of prematurity (ROP) is a leading cause of treatable childhood blindness.
- Current telemedicine screening for ROP relies on expensive equipment, limiting access in low-resource settings.
- Smartphone-based fundus imaging (SBFI) presents a potential solution for cost-effective, mobile ROP screening.
Purpose of the Study:
- To compare the feasibility of non-contact SBFI with conventional contact fundus imaging (CFI) for ROP screening and documentation.
- To evaluate the diagnostic accuracy of SBFI for ROP and associated "plus disease" compared to CFI.
Main Methods:
- Twenty-six eyes were imaged using both non-contact SBFI and conventional contact fundus imaging (CFI).
- Examination time, field-of-view, and level of detail were compared between SBFI and CFI.
- Agreement with clinical evaluation, sensitivity, and specificity for ROP and plus disease detection were assessed for both imaging methods.
Main Results:
- SBFI had a smaller field-of-view (1:2.5 ratio) and longer examination time (109.0 ± 57.8s vs. 75.9 ± 36.3s, p < 0.01) than CFI, but offered equal detail.
- Both SBFI and CFI demonstrated good agreement with clinical evaluations for ROP stage and plus disease detection.
- High sensitivity and specificity for detecting ROP and plus disease were achieved with both methods, with SBFI showing 90%/100% and 88%/93% for plus disease and ROP, respectively.
Conclusions:
- Smartphone-based fundus imaging (SBFI) is a viable, non-contact, low-cost alternative to CFI for ROP screening and documentation.
- SBFI has the potential to significantly enhance ROP care accessibility in middle- and low-resource settings.
- This technology could broaden access to essential eye care for premature infants in underserved populations.
Abstract:
Retinopathy of prematurity (ROP) is a frequent cause of treatable childhood blindness. The current dependency of telemedicine-based ROP screening on cost-intensive equipment does not meet the needs in economically disadvantaged regions. Smartphone-based fundus imaging (SBFI) allows for affordable and mobile fundus examination and, therefore, could facilitate cost-effective telemedicine-based ROP screening in low-resources settings. We compared non-contact SBFI and conventional contact fundus imaging (CFI) in terms of feasibility for ROP screening and documentation. Twenty-six eyes were imaged with both SBFI and CFI. Field-of-view was smaller (ratio of diameters, 1:2.5), level of detail was equal, and examination time was longer for SBFI as compared to CFI (109.0 ± 57.8 vs. 75.9 ± 36.3 seconds, p < 0.01). Good agreement with clinical evaluation by indirect funduscopy was achieved for assessment of plus disease and ROP stage for both SBFI (squared Cohen's kappa, 0.88 and 0.81, respectively) and CFI (0.86 and 0.93). Likewise, sensitivity/specificity for detection of plus disease and ROP was high for both SBFI (90%/100% and 88%/93%, respectively) and CFI (80%/100% and 100%/96%). SBFI is a non-contact and low-cost alternative to CFI for ROP screening and documentation that has the potential to considerably improve ROP care in middle- and low-resources settings.
