Smartphone-based Anterior Segment Imaging: A Comparative Diagnostic Accuracy Study of a Potential Tool for Blindness Prevalence Surveys.

Autor: Kumar A; Department of Cornea and Refractive Surgery, Aravind Eye Hospital, Madurai, India., Ali FS; Department of Ophthalmology, University of California, San Francisco, California, USA., Stevens VM; Francis I. Proctor Foundation, University of California, San Francisco, California, USA., Melo JS; Francis I. Proctor Foundation, University of California, San Francisco, California, USA., Venkatesh Prajna N; Department of Cornea and Refractive Surgery, Aravind Eye Hospital, Madurai, India., Lalitha P; Department of Ocular Microbiology, Aravind Eye Hospital, Madurai, India., Srinivasan M; Department of Cornea and Refractive Surgery, Aravind Eye Hospital, Madurai, India., Bhandari G; Bharatpur Eye Hospital, Bharatpur, Nepal., Bhandari S; Bharatpur Eye Hospital, Bharatpur, Nepal., Maamari RN; Francis I. Proctor Foundation, University of California, San Francisco, California, USA.; Department of Bioengineering and Biophysics Program, University of California, Berkeley, California, USA., Fletcher DA; Department of Bioengineering and Biophysics Program, University of California, Berkeley, California, USA., Lietman TM; Department of Ophthalmology, University of California, San Francisco, California, USA.; Francis I. Proctor Foundation, University of California, San Francisco, California, USA.; Department of Epidemiology & Biostatistics, University of California, San Francisco, USA.; Institute for Global Health, University of California, San Francisco, California, USA., Keenan JD; Department of Ophthalmology, University of California, San Francisco, California, USA.; Francis I. Proctor Foundation, University of California, San Francisco, California, USA.
Jazyk: angličtina
Zdroj: Ophthalmic epidemiology [Ophthalmic Epidemiol] 2022 Oct; Vol. 29 (5), pp. 491-498. Date of Electronic Publication: 2021 Oct 04.
DOI: 10.1080/09286586.2021.1980589
Abstrakt: Purpose: To determine if smartphone photography could be a useful adjunct to blindness prevalence surveys by providing an accurate diagnosis of corneal opacity.
Methods: A total of 174 patients with infectious keratitis who had undergone corneal culturing over the past 5 years were enrolled in a diagnostic accuracy study at an eye hospital in South India. Both eyes had an ophthalmologist-performed slit lamp examination, followed by anterior segment photography with a handheld digital single lens reflex (SLR) camera and a smartphone camera coupled to an external attachment that provided magnification and illumination. The diagnostic accuracy of photography was assessed relative to slit lamp examination.
Results: In total, 90 of 174 enrolled participants had a corneal opacity in the cultured eye and no opacity in the contralateral eye, and did not have a penetrating keratoplasty or missing photographs. Relative to slit lamp examination, the sensitivity of corneal opacity diagnosis was 68% (95%CI 58-77%) using the smartphone's default settings and 59% (95%CI 49-69%) using the SLR, and the specificity was 97% (95%CI 93-100%) for the smartphone and 97% (95%CI 92-100%) for the SLR. The sensitivity of smartphone-based corneal opacity diagnosis was higher for larger scars (81% for opacities 2 mm in diameter or larger), more visually significant scars (100% for eyes with visual acuity worse than 20/400), and more recent scars (85% for eyes cultured in the past 12 months).
Conclusion: The diagnostic performance of a smartphone coupled to an external attachment, while somewhat variable, demonstrated high specificity and high sensitivity for all but the smallest opacities.
Databáze: MEDLINE
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