• Pak J Med Sci · May 2023

    Smartphone-based fundus imaging for evaluation of Retinopathy of Prematurity in a low-income country: A pilot study.

    • Roha Ahmad Choudhary, Shiraz Hashmi, and Haroon Tayyab.
    • Roha Ahmad Choudhary, MBBS. Department of Ophthalmology and Visual Sciences, The Aga Khan University Hospital, Karachi Stadium, Stadium Road, Karachi, Pakistani.
    • Pak J Med Sci. 2023 May 1; 39 (3): 638643638-643.

    ObjectivesTo evaluate the feasibility of a novel and simple smart phone-based Retinopathy of Prematurity (ROP) screening approach in a resource-constrained setting.MethodsThis cross-sectional validation study was conducted at the Department of Ophthalmology and Neonatal Intensive Care Unit (NICU) of The Aga Khan University Hospital, Pakistan, from January 2022 to April 2022. A total of 63 images of eyes with active ROP (stage-1, 2, 3, 4 and/or plus or pre-plus disease) were included in this study. The stage of ROP was documented by the principal investigator using an indirect ophthalmoscope and retinal images were obtained using this novel technique. These images were shared with two masked ROP experts who rated the image quality and determined the stage of ROP and presence of plus disease. Their reports were compared with the initial findings reported by principal investigator using indirect ophthalmoscope.ResultsWe reviewed 63 images for image quality, stage of ROP and presence of plus disease. There was significant agreement between the gold standard and the Rater-1 and 2 for the presence of plus disease (Cohen's kappa was 0.84 and 1.0) and the stage of the disease (Cohen's kappa 0.65 and 1.0). There was significant agreement between the Rater for presence of plus disease and any stage of ROP (Cohen's κ: 0.84 and 0.65 for plus disease and any stage of the ROP, respectively). Rater-1 and 2 rated 96.83% and 98.41% images as excellent / acceptable respectively.ConclusionsHigh quality retinal images can be captured with a smartphone and 28D lens without using any additional adapter equipment. This approach of ROP screening can form basis of telemedicine for ROP in resource constrained areas.Copyright: © Pakistan Journal of Medical Sciences.

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