TY - JOUR
T1 - Comparison among methods of retinopathy assessment (CAMRA) study
T2 - Smartphone, nonmydriatic, and mydriatic photography
AU - Ryan, Martha E.
AU - Rajalakshmi, Ramachandran
AU - Prathiba, Vijayaraghavan
AU - Anjana, Ranjit Mohan
AU - Ranjani, Harish
AU - Narayan, K. M.Venkat
AU - Olsen, Timothy W.
AU - Mohan, Viswanathan
AU - Ward, Laura A.
AU - Lynn, Michael J.
AU - Hendrick, Andrew M.
N1 - Funding Information:
Supported by an unrestricted departmental grant from Research to Prevent Blindness, an Emory Ophthalmology departmental core grant (National Institutes of Health /National Eye Institute: P30 EY006360), the GO-Emory program, and National Institutes of Health Research Training Grant R25 TW009337 funded by the Fogarty International Center and the National Institute of Mental Health. The sponsors had no role in the design or conduct of this research.
Publisher Copyright:
© 2015 American Academy of Ophthalmology.
PY - 2015/10/1
Y1 - 2015/10/1
N2 - Purpose We compared smartphone fundus photography, nonmydriatic fundus photography, and 7-field mydriatic fundus photography for their abilities to detect and grade diabetic retinopathy (DR). Design This was a prospective, comparative study of 3 photography modalities. Participants Diabetic patients (n = 300) were recruited at the ophthalmology clinic of a tertiary diabetes care center in Chennai, India. Methods Patients underwent photography by all 3 modalities, and photographs were evaluated by 2 retina specialists. Main Outcome Measures The sensitivity and specificity in the detection of DR for both smartphone and nonmydriatic photography were determined by comparison with the standard method, 7-field mydriatic fundus photography. Results The sensitivity and specificity of smartphone fundus photography, compared with 7-field mydriatic fundus photography, for the detection of any DR were 50% (95% confidence interval [CI], 43-56) and 94% (95% CI, 92-97), respectively, and of nonmydriatic fundus photography were 81% (95% CI, 75-86) and 94% (95% CI, 92-96%), respectively. The sensitivity and specificity of smartphone fundus photography for the detection of vision-threatening DR were 59% (95% CI, 46-72) and 100% (95% CI, 99-100), respectively, and of nonmydriatic fundus photography were 54% (95% CI, 40-67) and 99% (95% CI, 98-100), respectively. Conclusions Smartphone and nonmydriatic fundus photography are each able to detect DR and sight-threatening disease. However, the nonmydriatic camera is more sensitive at detecting DR than the smartphone. At this time, the benefits of the smartphone (connectivity, portability, and reduced cost) are not offset by the lack of sufficient sensitivity for detection of DR in most clinical circumstances.
AB - Purpose We compared smartphone fundus photography, nonmydriatic fundus photography, and 7-field mydriatic fundus photography for their abilities to detect and grade diabetic retinopathy (DR). Design This was a prospective, comparative study of 3 photography modalities. Participants Diabetic patients (n = 300) were recruited at the ophthalmology clinic of a tertiary diabetes care center in Chennai, India. Methods Patients underwent photography by all 3 modalities, and photographs were evaluated by 2 retina specialists. Main Outcome Measures The sensitivity and specificity in the detection of DR for both smartphone and nonmydriatic photography were determined by comparison with the standard method, 7-field mydriatic fundus photography. Results The sensitivity and specificity of smartphone fundus photography, compared with 7-field mydriatic fundus photography, for the detection of any DR were 50% (95% confidence interval [CI], 43-56) and 94% (95% CI, 92-97), respectively, and of nonmydriatic fundus photography were 81% (95% CI, 75-86) and 94% (95% CI, 92-96%), respectively. The sensitivity and specificity of smartphone fundus photography for the detection of vision-threatening DR were 59% (95% CI, 46-72) and 100% (95% CI, 99-100), respectively, and of nonmydriatic fundus photography were 54% (95% CI, 40-67) and 99% (95% CI, 98-100), respectively. Conclusions Smartphone and nonmydriatic fundus photography are each able to detect DR and sight-threatening disease. However, the nonmydriatic camera is more sensitive at detecting DR than the smartphone. At this time, the benefits of the smartphone (connectivity, portability, and reduced cost) are not offset by the lack of sufficient sensitivity for detection of DR in most clinical circumstances.
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U2 - 10.1016/j.ophtha.2015.06.011
DO - 10.1016/j.ophtha.2015.06.011
M3 - Article
C2 - 26189190
AN - SCOPUS:84943449940
SN - 0161-6420
VL - 122
SP - 2038
EP - 2043
JO - Ophthalmology
JF - Ophthalmology
IS - 10
ER -