1. WIDE-FIELD BEDSIDE IMAGING OF THE HUMAN RETINA USING A SMARTPHONE HOLDER
LIANNA M. VALDES,* DOV B. SEBROW,* ERIC L. TONG,† AND TONGALP H. TEZEL*
METHODS:
A polyurethane mount was designed and constructed to keep the camera module of a iPhone 4S aligned with the assistant mirror of an indirect ophthalmoscope.
Using the FilmicPro iPhone application (Cinegenix LLC, Seattle, WA), indirect ophthalmoscopy was recorded during routine exams of numerous subjects to optimize lighting and focusing conditions for video and photography of the fundus.
Next, for 8 subjects with known fundus pathologies, fundus images were obtained using both the prototype device and a standard fundus camera (Zeiss FF450, Dublin CA) (Figure 1).
Images were extracted from video using the software Free Studio 6.3 (DVDVideoSoft, U.K.). A survey containing both prototype and fundus camera images from the 8 subjects, designed to compare clarity and ease of diagnosis of fundus pathologies between the two imaging modalities, was given to 8 masked ophthalmologists.
Recently, a mount for the iPhone 6 was designed based on the original prototype (Figure 2).
*Department of Ophthalmology, Edward S. Harkness Eye Institute, Columbia University Medical Center, New York, NY
†School of Engineering and Applied Sciences, Columbia University, New York, NY
RESULTS:
HIGH-QUALITY IMAGING OF THE POSTERIOR POLE AND RETINAL PERIPHERY WAS ACHIEVED USING OUR NOVEL iPHONE ADAPTER FOR THE INDIRECT OPHTHALMOSCOPE.
BEST RESULTS WERE OBTAINED WHEN POSITIONING THE iPHONE CAMERA 0.5 CM FROM THE ASSISTANT MIRROR AND USING MEDIUM INTENSITY ILLUMINATION FROM THE INDIRECT OPHTHALMOSCOPE.
WHEN LOOKING AT THE FUNDUS IMAGES CAPTURED BY THE SMARTPHONE CAMERA, SURVEY PARTICIPANTS ACCURATELY DESCRIBED THE DETAILS OF FUNDUS PATHOLOGIES 73% OF THE TIME.
AFTER THE CORRESPONDING STANDARD FUNDUS PHOTOS WERE VIEWED, ONLY 20% OF INITIAL DIAGNOSES WERE CHANGED CORRECTLY BY PARTICIPANTS.
THE iPHONE CAMERA WAS EASY TO USE AND WAS ABLE TO IMAGE FAR PERIPHERAL LESIONS THAT WERE LOCATED BEYOND THE CAPTURE RANGE OF THE STATIONARY FUNDUS CAMERA, ALLOWING FOR DOCUMENTATION OF A PERIPHERAL RETINAL LESION DURING DYNAMIC SCLERAL DEPRESSION (FIGURE 3).
WE WERE ABLE TO CREATE A MONTAGE OUT OF STILLS GENERATED FROM EXAMINATION OF A NORMAL RETINA USING THE PROTOTYPE DEVICE (FIGURE 4).
PURPOSE:
TO CONSTRUCT AND EVALUATE THE CLINICAL UTILITY OF A SMARTPHONE ATTACHMENT TO A BINOCULAR INDIRECT OPHTHALMOSCOPE FOR CAPTURING WIDE-ANGLE IMAGES AND VIDEO RECORDINGS OF THE FUNDUS AT BEDSIDE.
CONCLUSIONS:
THE iPHONE ADAPTER FOR THE INDIRECT OPHTHALMOSCOPE CAN INDEED PROVIDE CLINICALLY USEFUL IMAGING OF THE POSTERIOR POLE AND RETINAL PERIPHERY.
THIS EFFICIENT, COST-EFFECTIVE, AND PORTABLE IMAGING MODALITY WILL FACILITATE RAPID ACQUISITION, STORAGE, AND TRANSMISSION OF FUNDUS IMAGES IN THE PEDIATRIC POPULATION AND IN PATIENTS UNABLE TO SIT FOR STANDARD FUNDUS PHOTOGRAPHY, SUCH AS THOSE IN THE ICU.
WE BELIEVE THIS TECHNOLOGY WILL BE ESPECIALLY USEFUL FOR DOCUMENTING AND MONITORING FUNDUS CHANGES IN RETINOPATHY OF PREMATURITY.
Disclosures: Lianna M. Valdes – none; Dov B. Sebrow – none; Eric L. Tong – none; Tongalp H. Tezel – none. All patients were consented per IRB protocol. Funding provided by the Columbia University College of Physicians and Surgeons Scholarly Project Program.
correspondence: