Diagnostic accuracy of handheld fundus photography: A comparative study of three commercially available cameras

Louisa Lu; Somsanguan Ausayakhun; Sakarin Ausayakuhn; Preeyanuch Khunsongkiet; Atitaya Apivatthakakul; Catherine Q Sun; Tyson N Kim; Michele Lee; Edmund Tsui; Plern Sutra; Jeremy D Keenan

doi:10.1371/journal.pdig.0000131

Diagnostic accuracy of handheld fundus photography: A comparative study of three commercially available cameras

PLOS Digit Health. 2022 Nov 2;1(11):e0000131. doi: 10.1371/journal.pdig.0000131. eCollection 2022 Nov.

Authors

Louisa Lu^{1

2}, Somsanguan Ausayakhun^{3

4}, Sakarin Ausayakuhn⁵, Preeyanuch Khunsongkiet⁵, Atitaya Apivatthakakul³, Catherine Q Sun^{1

6}, Tyson N Kim⁶, Michele Lee⁷, Edmund Tsui^{1

6}, Plern Sutra¹, Jeremy D Keenan^{1

6}

Affiliations

¹ Francis I. Proctor Foundation, University of California, San Francisco, San Francisco, California, United States of America.
² Department of Ophthalmology, Stanford University, Stanford, California, United States of America.
³ Department of Ophthalmology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
⁴ CMU Lasik Center, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
⁵ Sriphat Medical Center, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
⁶ Department of Ophthalmology, University of California, San Francisco, San Francisco, California, United States of America.
⁷ Department of Ophthalmology, University of Washington, Seattle, Washington, United States of America.

Abstract

The objective of this study was to compare the sensitivity and specificity of handheld fundus cameras in detecting diabetic retinopathy (DR), diabetic macular edema (DME), and macular degeneration. Participants in the study, conducted at Maharaj Nakorn Hospital in Northern Thailand between September 2018 and May 2019, underwent an ophthalmologist examination as well as mydriatic fundus photography with three handheld fundus cameras (iNview, Peek Retina, Pictor Plus). Photographs were graded and adjudicated by masked ophthalmologists. Outcome measures included the sensitivity and specificity of each fundus camera for detecting DR, DME, and macular degeneration, relative to ophthalmologist examination. Fundus photographs of 355 eyes from 185 participants were captured with each of the three retinal cameras. Of the 355 eyes, 102 had DR, 71 had DME, and 89 had macular degeneration on ophthalmologist examination. The Pictor Plus was the most sensitive camera for each of the diseases (73-77%) and also achieved relatively high specificity (77-91%). The Peek Retina was the most specific (96-99%), although in part due to its low sensitivity (6-18%). The iNview had slightly lower estimates of sensitivity (55-72%) and specificity (86-90%) compared to the Pictor Plus. These findings demonstrated that the handheld cameras achieved high specificity but variable sensitivities in detecting DR, DME, and macular degeneration. The Pictor Plus, iNview, and Peek Retina would have distinct advantages and disadvantages when applied for utilization in tele-ophthalmology retinal screening programs.

Copyright: © 2022 Lu et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Grants and funding

This work was supported by donations from the JaMel and Tom Perkins Family Foundation and the Fortisure Foundation to JDK and by donations from The All May See Foundation and Research to Prevent Blindness to the University of California San Francisco Department of Ophthalmology. LL was supported by an International Clinical Research Fellowship from the Fulbright U.S. Student Program and the Doris Duke Charitable Foundation. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.