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. 2018 Dec 11:12:2581-2589.
doi: 10.2147/OPTH.S182022. eCollection 2018.

Agreement between retinal images obtained via smartphones and images obtained with retinal cameras or fundoscopic exams - systematic review and meta-analysis

Manuel Ap Vilela  1   2 , Felipe M Valença  1 , Pedro Km Barreto  1 , Carlos Ev Amaral  1 , Lúcia C Pellanda  1   2
Affiliations

Agreement between retinal images obtained via smartphones and images obtained with retinal cameras or fundoscopic exams - systematic review and meta-analysis

Manuel Ap Vilela et al. Clin Ophthalmol. .

Abstract

Background: Smartphone fundoscopy is a new option for visualizing the ocular fundus but must be validated before being included in population-based examinations. Our aim was to evaluate the quality of fundoscopic images obtained via smartphone and to compare their agreement with retinal camera images or clinical examination.

Methods: The database for this study included all observational studies with smartphone fundoscopy that have comparative analyses with the gold standard methods.

Results: Out of 121 potentially relevant studies, nine were included in this analysis, comprising a total of 4,219 eyes. Mean age was 56.6 years (SD±8.5). Combined kappa (κ) agreement statistics were equal to 77.77% (95% CI: 70.34%, 83.70%). No heterogeneity was measured by random effects (I 2=zero).

Conclusion: Fundoscopic images obtained by using smartphones have substantial agreement with gold standards for clinical or photographic exams.

Keywords: fundoscopy; ophthalmoscopy; smartphones.

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Conflict of interest statement

Disclosure The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
Flowchart of the studies.
Figure 2
Figure 2
Forest plot of the agreement between smartphones and retinal cameras. Abbreviations: Q, heterogeneity among studies – fixed effects; I, between-studies variability (%)-fixed effects; Qv, heterogeneity among studies – random effects; Iv, between-studies variability (%)-random effects; es, effect summary; CI, confidence interval; SE, standard error; CI lower, lower confidence interval; CI upper, upper confidence interval.
Figure 3
Figure 3
ROC curve. Note: Data from five studies.–,, Abbreviations: AUC, area under the curve; ROC, receiver operating characteristic.
Figure 4
Figure 4
Assessment of risk of bias.
See this image and copyright information in PMC

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