Smartphone-based, rapid, wide-field fundus photography for diagnosis of pediatric retinal diseases

Tapan P. Patel, Tyson N. Kim, Gina Yu, Vaidehi S. Dedania, Philip Lieu, Cynthia X. Qian, Cagri G. Besirli, Hakan Demirci, Todd Margolis, Daniel A. Fletcher, Yannis M. Paulus

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: An important, unmet clinical need is for cost-effective, reliable, easy-to-use, and portable retinal photography to evaluate preventable causes of vision loss in children. This study presents the feasibility of a novel smartphone-based retinal imaging device tailored to imaging the pediatric fundus. Methods: Several modifications for children were made to our previous device, including a child-friendly 3D printed housing of animals, attention-grabbing targets, enhanced image stitching, and video-recording capabilities. Retinal photographs were obtained in children undergoing routine dilated eye examination. Experienced masked retina-specialist graders determined photograph quality and made diagnoses based on the images, which were compared to the treating clinician’s diagnosis. Results: Dilated fundus photographs were acquired in 43 patients with a mean age of 6.7 years. The diagnoses included retinoblastoma, Coats’ disease, commotio retinae, and optic nerve hypoplasia, among others. Mean time to acquire five standard photographs totaling 90-degree field of vision was 2.3 ± 1.1 minutes. Patients rated their experience of image acquisition favorably, with a Likert score of 4.6 ± 0.8 out of 5. There was 96% agreement between image-based diagnosis and the treating clinician’s diagnosis. Conclusions: We report a handheld smartphone-based device with modifications tailored for wide-field fundus photography in pediatric patients that can rapidly acquire fundus photos while being well-tolerated. Translational Relevance: Advances in handheld smartphone-based fundus photography devices decrease the technical barrier for image acquisition in children and may potentially increase access to ophthalmic care in communities with limited resources.

Original languageEnglish (US)
Article number29
JournalTranslational Vision Science and Technology
Volume8
Issue number3
DOIs
StatePublished - May 2019
Externally publishedYes

Keywords

  • Fundus photography
  • Pediatric retina
  • Portable imaging
  • Smartphone
  • Wide-field

ASJC Scopus subject areas

  • Biomedical Engineering
  • Ophthalmology

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