Predictors of Photographic Quality with a Handheld Nonmydriatic Fundus Camera Used for Screening of Vision-Threatening Diabetic RetinopathyDavila J.R.a · Sengupta S.S.c · Niziol L.M.a · Sindal M.D.c · Besirli C.G.a · Upadhyaya S.c · Woodward M.A.a · Venkatesh R.c · Robin A.L.a, b · Grubbs Jr. J.a · Newman-Casey P.A.a
aDepartment of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, MI, and bDepartment of Ophthalmology, University of Maryland, Baltimore, MD, USA; cAravind Eye Hospital and Postgraduate Institute of Ophthalmology, Pondicherry, India
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Article / Publication Details
Purpose: To analyze predictors of image quality for a handheld nonmydriatic fundus camera used for screening of vision-threatening diabetic retinopathy. Methods: An ophthalmic photographer at an Aravind Eye Hospital obtained nonmydriatic and mydriatic fundus images from 3 fields in 275 eyes of 155 participants over 13 months using a Smartscope camera (Optomed, Oulu, Finland) and a Topcon tabletop fundus camera (Topcon, Tokyo, Japan). Two fellowship-trained retina specialists graded the images. Repeated-measures logistic regression assessed predictors of the main outcome measure: gradability of the fundus images. Results: Of 2,475 images, 76.2% of the Smartscope nonmydriatic images, 90.1% of the Smartscope mydriatic images, and 92.0% of the Topcon mydriatic images were gradable. Eyes with vitreous hemorrhage (OR = 0.24, p < 0.0001) or advanced cataract (OR = 0.08, p < 0.0001) had decreased odds of image gradability. Excluding eyes with cataract or vitreous hemorrhage, nonmydriatic macular image gradability improved from 68.4% in the first set of 55 eyes to 94.6% in the final set of 55 eyes. Conclusion: With sufficient training, paraprofessional health care staff can obtain high-quality images with a portable nonmydriatic fundus camera, particularly in patients with clear lenses and clear ocular media.
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