Predictors of Photographic Quality with a Handheld Nonmydriatic Fundus Camera Used for Screening of Vision-Threatening Diabetic Retinopathy

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

Research output: Contribution to journalArticle

Abstract

Purpose: To analyze predictors of image quality for a handheld nonmydriatic fundus camera used for screening of vision-threatening diabetic retinopathy. Methods: An ophthalmic photographer at an Aravind Eye Hospital obtained nonmydriatic and mydriatic fundus images from 3 fields in 275 eyes of 155 participants over 13 months using a Smartscope camera (Optomed, Oulu, Finland) and a Topcon tabletop fundus camera (Topcon, Tokyo, Japan). Two fellowship-trained retina specialists graded the images. Repeated-measures logistic regression assessed predictors of the main outcome measure: gradability of the fundus images. Results: Of 2,475 images, 76.2% of the Smartscope nonmydriatic images, 90.1% of the Smartscope mydriatic images, and 92.0% of the Topcon mydriatic images were gradable. Eyes with vitreous hemorrhage (OR = 0.24, p < 0.0001) or advanced cataract (OR = 0.08, p < 0.0001) had decreased odds of image gradability. Excluding eyes with cataract or vitreous hemorrhage, nonmydriatic macular image gradability improved from 68.4% in the first set of 55 eyes to 94.6% in the final set of 55 eyes. Conclusion: With sufficient training, paraprofessional health care staff can obtain high-quality images with a portable nonmydriatic fundus camera, particularly in patients with clear lenses and clear ocular media.

Original languageEnglish (US)
Pages (from-to)89-99
Number of pages11
JournalOphthalmologica
DOIs
StateAccepted/In press - Jul 5 2017
Externally publishedYes

Keywords

  • Diabetic retinopathy
  • Image quality
  • Screening
  • Telemedicine

ASJC Scopus subject areas

  • Ophthalmology
  • Sensory Systems

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  • Cite this

    Davila, J. R., Sengupta, S. S., Niziol, L. M., Sindal, M. D., Besirli, C. G., Upadhyaya, S., Woodward, M. A., Venkatesh, R., Robin, A. L., Grubbs, J., & Newman-Casey, P. A. (Accepted/In press). Predictors of Photographic Quality with a Handheld Nonmydriatic Fundus Camera Used for Screening of Vision-Threatening Diabetic Retinopathy. Ophthalmologica, 89-99. https://doi.org/10.1159/000475773