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Smartphone Fundus Photography
Published on: July 6, 2017
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Remote Screening for Optic Nerve Cupping Using Smartphone-based Nonmydriatic Fundus Photography
Lauren C LaMonica1, Mahesh K Bhardwaj2, Nicola L Hawley1
1Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT.
Journal of Glaucoma
|September 24, 2020
Summary
Smartphone fundus photography enables remote glaucoma screening in Samoa, showing strong agreement between graders for optic nerve assessment. This low-cost method can identify patients needing further ophthalmologic evaluation.
Area of Science:
- Ophthalmology
- Medical Imaging
- Public Health
Background:
- Glaucoma screening is challenging in underserved regions like Samoa, which has limited ophthalmologists.
- Remote screening using nonmydriatic fundus photography can overcome geographical and resource barriers.
Purpose of the Study:
- To evaluate the effectiveness of smartphone-based nonmydriatic fundus photography for remote glaucoma screening.
- To assess inter-rater agreement in grading optic disc status using this technology.
Main Methods:
- Color fundus photographs were captured using a smartphone-based device by lay examiners in Samoa.
- Images were remotely graded by ophthalmologists and optometrists, with high-risk cases escalated.
- Image quality metrics (brightness, contrast, focus) and cup-to-disc ratio (CDR) were analyzed.
Main Results:
- Features suggestive of glaucoma were found in 16.0% of participants.
- Strong inter-grader agreement was observed (90.3%, κ=0.53).
- Cup brightness was significantly associated with CDR, with brighter discs indicating higher CDR.
Conclusions:
- Smartphone-based fundus photography is a viable, low-cost tool for remote screening of optic nerve changes indicative of glaucoma.
- This method, combined with risk factor assessment, can aid in identifying patients for further ophthalmologic referral.
