Smartphone Ophthalmoscopy Can Screen for Diabetic Retinopathy

Dr. Andrea Russo Medico Chirurgo - Specialista in Oculistica Università degli Studi di Brescia Brescia Interview with:
Dr. Andrea Russo
Medico Chirurgo – Specialista in Oculistica
Università degli Studi di Brescia Brescia Italy

Medical Research: What is the background for this study? What are the main findings?

Dr. Russo: When I finished my residency program in Ophthalmology two years ago I realized that many patients were referred to me to assess and classify diabetic and hypertensive retinopathy. Therefore, I started wondering if there was an ophthalmoscopy method to make General Practitioners and Internist Physicians independent for these screening retinal assessments. I thought that we all own a personal computer connected with a (high quality) camera in our pocket and therefore smartphone ophthalmoscopy was feasible. Both the indirect and direct ophthalmoscopy techniques were suitable, however the latter was much easier to obtain. Furthermore, direct ophthalmoscopy can exploit smartphones’ autofocus and flash LED light making the required optics very simple and inexpensive. I purchased my 3D printer and started realizing very first working prototypes. A few months were required to improve the light path to eliminate internal and corneal reflections. Finally, I patented the optical solution and joined my partner Si14 S.p.A. (Padova, Italy) for the industrialization process.

The main findings are that that smartphone ophthalmoscopy with the D-Eye system can accurately detect retinal lesions for grading diabetic retinopathy. Furthermore, we noticed an amazing convenience in the assessment of babies, since they seem to be spontaneously attracted by the non-disturbing light emitted by the device, making the fundus acquisition straightforward. The advantages of smartphone-based retinal image acquisition for remote, non-hospital settings include portability and immediate upload/analysis. Indeed, telemedicine has the potential to reach patients and communities that currently receive negligible or suboptimal eye care as a result of geographic or sociocultural barriers, or both.

Medical Research: What should clinicians and patients take away from your report?

Dr. Russo: The take home message of my report is that smartphone ophthalmoscopy is a convenient and valid technique to perform screenings for retinal diseases like diabetic retinopathy. The combination of affordability, portability, connectivity, and easy-to-use features of this ophthalmoscopy system provides a foundational platform, based on which a number of revolutionary screening programs can potentially be designed.

Medical Research: What recommendations do you have for future research as a result of this study?

Dr. Russo: Our study had some limitations. The smartphone ophthalmoscopy was performed by a retina specialist, therefore the reported results can not be directly transposed to a non-ophthalmologist technician. Therefore, future research is needed to deeper validate smartphone ophthalmoscopy, especially among non-ophthalmic physicians and personnel. Given the easiness to visualize and record the optic nerve head with undiluted pupil in just a few seconds, future studies should also consider the opportunity to screen for glaucoma.


Comparison of Smartphone Ophthalmoscopy with Slit-lamp Biomicroscopy for Grading Diabetic Retinopathy

Russo, Andrea et al. American Journal of Ophthalmology
Published Online: November 07, 2014


Last Updated on November 12, 2014 by Marie Benz MD FAAD