Innovation in neuro-ophthalmology: The validation of smartphone-based self-screening for early detection of disorders

This diagnosis study evaluated the diagnostic validity of Neuro-ophthalmology Disorder Early Screening (NODES), a telemedicine-based smartphone application that integrates structured anamnesis and simple neuro-ophthalmology examination for early detection of neuro-ophthalmological disorders.

This study was conducted at Sardjito Eye Center Neuro-ophthalmology subdivision, assessing the diagnostic validity of the NODES mobile application of 16 neuro-ophthalmology diagnoses compared to confirmative diagnoses of neuro-ophthalmologists. A total of 126 participants meeting inclusion criteria underwent two treatments: simple examination using the NODES application, compared to confirmative examination by neuro-ophthalmologists. Standard protocols were integrated into both treatments to evaluate the diagnosis accuracy of the examination.

NODES showcase promising results as a new diagnostic tool for these four disorders; myasthenia gravis (MG) with the area under the curve (AUC) =0.951, multicranial nerve palsy orbital apex (MNP OA) with AUC = 0.900, monocranial nerve palsy N.III (MNP N.III) with AUC = 0.824, and monocranial sixth nerve palsy (MNP N.VI) with AUC = 0.764.

The NODES application can be used as a new diagnostic screening tool for several euro-ophthalmology diagnoses including MG, multicranial nerve palsy orbital apex, monocranial nerve palsy N.III, and monocranial sixth nerve palsy. The high specificity of NODES in other neuro-ophthalmology diagnoses can be quite useful to identify individuals without the condition, reducing the occurrence of false positives and crucial in preventing unnecessary stress, further testing, and potential misdiagnoses for those who do not actually have the condition.