Comparison of Smartphone Ophthalmoscopy With Slit-Lamp Biomicroscopy for Grading Diabetic Retinopathy
Comparison of Smartphone Ophthalmoscopy With Slit-Lamp Biomicroscopy for Grading Diabetic Retinopathy
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DOI：
10.1016/j.ajo.2014.11.008
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发表时间：
2015-02-01
影响因子：
4.2
通讯作者：
Semeraro, Francesco
中科院分区：
文献类型：
--
作者：
Russo, Andrea;Morescalch, Francesco;Semeraro, Francesco
目的：比较智能眼底镜和裂隙灯生物显微镜对糖尿病视网膜病变(DR)分级的准确性和可靠性。设计：基于临床的前瞻性对比仪器研究。方法：对120例(240眼)门诊1型和2型DM患者进行对比临床研究。散瞳后，患者用D-Eye设备进行智能眼底镜检查，然后进行散光视网膜裂隙灯检查，根据5步评分标准对DR进行分级。结果：240只眼中204只眼(85%)总体上与两种方法符合(简单K=0.78；CI 0.71~0.84)，1步内符合232只眼(96.7%)。与生物显微镜相比，智能眼底镜检测黄斑水肿的敏感度和特异度分别为81%和98%。9只眼(3.75%)和4只眼(1.7%)因白内障和/或小瞳孔无法使用智能手机检眼镜进行眼底检查和DR分级。结论：智能手机检眼镜和散光视网膜生物显微镜对DR的分级具有很好的一致性，智能手机检眼镜的便携性、价格和连接性使智能手机检眼镜成为社区筛查项目的一项有前途的技术。(C)2015年，爱思唯尔公司。保留所有权利。
PURPOSE: To assess the accuracy and reliability of smartphone ophthalmoscopy, we compared the ability of a smartphone ophthalmoscope with that of a slit-lamp biomicroscope to grade diabetic retinopathy (DR) in patients with diabetes mellitus (DM).DESIGN: Clinical-based, prospective, comparative instrument study.METHODS: This comparative clinical study was performed in 120 outpatients (240 eyes) with type 1 or type 2 DM. After pupil dilation, the patients underwent smartphone ophthalmoscopy with the D-Eye device, followed by dilated retinal slit-lamp examination, to grade DR according to a 5-step scale.RESULTS: Overall exact agreement between the 2 methods was observed in 204 of 240 eyes (85%) (simple K = 0.78; CI 0.71-0.84) and agreement within 1 step was observed in 232 eyes (96.7%). Compared to biomicroscopy, the sensitivity and specificity of smartphone ophthalmoscopy for the detection of clinically significant macular edema were 81% and 98%, respectively. Smart-phone ophthalmoscopy and biomicroscopy could not be used to examine the fundus and grade DR in 9 eyes (3.75%) and 4 eyes (1.7%), respectively, because of cataract and/or small pupil diameter.CONCLUSION: Smartphone ophthalmoscopy showed considerable agreement with dilated retinal biomicroscopy for the grading of DR. The portability, affordability, and connectivity of a smartphone ophthalmoscope make smartphone ophthalmoscopy a promising technique for community screening programs. (C) 2015 by Elsevier Inc. All rights reserved.