Diabetic Retinopathy Screening Using a Portable Retinal Camera in Vanuatu

Area of Science:

• Ophthalmology
• Diabetology
• Medical Technology

Background:

• Vanuatu faces high rates of diabetes and its complications.
• There is a significant shortage of ophthalmologists in Vanuatu.
• Diabetic retinopathy screening is crucial for preventing vision loss.

Purpose of the Study:

• To assess the feasibility of using a portable, all-in-one retinal camera for diabetic retinopathy screening.
• To evaluate the quality of retinal images obtained in a resource-limited setting.
• To determine the prevalence of diabetic retinopathy in a diabetic population in Vanuatu.

Main Methods:

• A proof-of-concept study was conducted in Vanuatu from February 10-28, 2020.
• 49 patients with diabetes mellitus from three islands were enrolled.
• Retinal images were captured using a non-mydriatic, handheld Volk Pictor Plus camera.

Main Results:

• Eleven participants (24%) exhibited referral-warranted diabetic retinopathy.
• Inter-rater reliability for referral status, retinopathy severity, and macular edema was moderately high (κ = 0.62, 0.76, 0.50 respectively).
• Retinal images of sufficient quality for screening were obtained.

Conclusions:

• Portable handheld retinal cameras are feasible for diabetic retinopathy screening in resource-limited environments like Vanuatu.
• A high prevalence (24%) of referral-warranted diabetic retinopathy was observed in the study cohort.
• This technology can help overcome barriers to eye care in underserved regions.