mHealth Research Digest by Tim Bredrup
Teleophthalmology, the electronic exchange of ophthalmic information to provide remote eye care services, has conventionally been executed on a standard office computer workstation. However, ophthalmologists in Pittsburgh, PA recently compared the diagnostic capability of an iPhone against a typical computer workstation for remote photographic evaluation of the fundus in diabetic retinopathy.
Fundus images, pictures of the inner eye portion that are visible when looking through the pupil during an eye examination, were captured using a non-mydriatic (does not dilate pupils) camera on consenting participants. The images and other medical data were then transmitted 20 miles away using an internet connected computer workstation and via an iPhone to two ophthalmologists who independently compared them.
According to the researchers, Kappa coefficient “between the gold standard workstation display and iPhone images to detect retinopathy-related changes for both readers was more than 0.9. The image quality of the iPhone was scored high by the ophthalmologists.”
The differences between transmitting ophthalmic images through an iPhone and a computer workstation Internet connection were deemed as stasticially insignificant. “Despite current limitations, smartphones could represent as a tool for fundus photo assessments of diabetic retinopathy,” the researchers concluded although they added that “further studies are needed to investigate the economic and clinical feasibility of smartphones in ophthalmology.”
One of the authors, Sajeesh Kumar, has since shared with iMedicalApps that “detecting small lesions such as microaneurysm has been a clinical challenge in teleophthalmology” and that his team is beginning a study to focus on this challenge with the new iPad’s 2048×1536 HD display.
Authors: Sajeesh Kumar, Ph.D, Erh-Hsuan Wang, M.S, Michael J. Pokabla, D.O., M.S., Robert J. Noecker, M.D., M.B.A.
Institutions: Department of Health Information Management, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA, University of Pittsburgh Medical Center Eye Center, Department of Ophthalmology, University of Pittsburgh, Pittsburgh, PA.
Original Abstract: PubMed