Nonmydriatic fundus photography in a high-risk population of Samoans with diabetes: The Soifua Manuia eye screening program.
Nonmydriatic fundus photography in a high-risk population of Samoans with diabetes: The Soifua Manuia eye screening program.
复制标题
萨摩亚糖尿病高危人群的免散瞳眼底摄影：Soifua Manuia 眼部筛查计划。
DOI：
10.1111/ceo.13527
复制
发表时间：
2019
影响因子：
4
通讯作者：
Ramsey,DavidJ
中科院分区：
文献类型：
--
作者：
LaMonica,LaurenC;Hawley,NicolaL;Bhardwaj,MaheshK;Naseri,Take;Reupena,MuagatutiaS;Ramsey,DavidJ
基于智能手机的非散瞳眼底照相机的出现允许高度移动的、潜在地具有成本效益的筛查程序能够到达偏远和服务不足的地区。经过培训的提供者可以用检眼镜和其他便携式设备进行快速和廉价的筛查。1虽然眼科远程医疗项目已经表明，数字图像可以由非眼科提供者以合理的特异性和灵敏度获得，但很少有研究探索使用便携式仪器进行远程诊断的潜力。2此外，迄今为止还没有研究在太平洋地区进行糖尿病筛查计划，该地区是全球糖尿病发病率最高的地区。3我们试用了一种低成本的、基于智能手机的远程视网膜诊断系统，以筛查患有糖尿病和血糖水平升高的萨摩亚高危人群的糖尿病视网膜病变（支持信息表S1）。我们的目标是确定可以使用PanOptic iExaminer系统（Welch Allyn Inc.，纽约）。本研究是与正在进行的萨摩亚人肥胖症和糖尿病遗传学纵向研究-Soifua Manuia（“良好健康”）研究-同时进行的，该研究是对约700名萨摩亚成年人的便利抽样进行的一项以村庄为基础的筛查。参与者经历了用连接到iPhone 6S的PanOptic iExaminer（苹果公司，加州）。该手持式仪器提供的眼底视图是标准直接检眼镜的5倍（约25 vs 5）。4使用3.5 V可充电电源手柄在现场为器械供电。
The advent of smartphone-based, non-mydriatic fundus cameras permits highly mobile, potentially cost-effective screening programs capable of reaching remote and underserved areas. Screening with ophthalmoscopes and other portable devices can be performed quickly and inexpensively by trained providers. 1 While ocular telehealth programs have revealed that digital images can be procured by non-ophthalmic providers with reasonable specificity and sensitivity, few studies have explored the potential for remote diagnosis using portable instruments. 2 Furthermore, no study to date has undertaken a diabetic screening program in the Pacific, a region facing some of the highest rates of diabetes globally. 3We piloted a low-cost, smartphone-based remote retinal diagnosis system to screen for diabetic retinopathy in a high-risk population of Samoans with diabetes and elevated blood glucose levels (Supporting Information Table S1). Our objective was to determine the percentage of gradable images that could be obtained using the PanOptic iExaminer System (Welch Allyn Inc., New York). The present study was undertaken alongside an ongoing longitudinal study of the genetics of obesity and diabetes among Samoans, the Soifua Manuia (“Good Health”) study, a village-based screening of a convenience sample of approximately 700 Samoan adults. Participants underwent a non-mydriatic, bilateral eye examination performed with the PanOptic iExaminer attached to an iPhone 6S (Apple Inc., California). This handheld instrument provides a 5-fold larger view of the fundus than a standard direct ophthalmoscope (approximately 25 vs 5). 4 A 3.5 V re-chargeable power handle was used to power the device in the field.