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Review
. 2023 Oct 6:17:2957-2965.
doi: 10.2147/OPTH.S423845. eCollection 2023.

A Systematic Review of Digital Ophthalmoscopes in Medicine

Rafael Robles  1 , Nikhil Patel  2 , Emily Neag  2 , Ajay Mittal  3 , Zahra Markatia  2 , Kambiz Ameli  2 , Benjamin Lin  2
Affiliations
Review

A Systematic Review of Digital Ophthalmoscopes in Medicine

Rafael Robles et al. Clin Ophthalmol. .

Abstract

Purpose: Recent advances in telemedicine have led to increased use of digital ophthalmoscopes (DO) in clinical settings. This review aims to assess commercially available DOs, including smartphone (SP), desktop, and handheld ophthalmoscopes, and evaluate their applications.

Methods: A literature review was performed by searching PubMed (pubmed.ncbi.nlm.nih.gov), Web of Science (webofknowledge.com), and Science Direct (sciencedirect.com). All English-language papers that resulted from the search terms "digital ophthalmoscope", "screening tool", "glaucoma screening", "diabetic retinopathy screening", "cataract screening", and "papilledema screening" were reviewed. Studies that contained randomized clinical trials with human participants between January 2010 and December 2020 were included. The Risk of Bias in Systematic Reviews (ROBIS) tool was used to assess the methodological quality of each included paper.

Results: Of the 1307 studies identified, 35 met inclusion and exclusion criteria. The ROBIS tool determined that 29/35 studies (82.8%) had a low risk of bias, 3/35 (8.5%) had a moderate risk of bias, and 3/35 (8.5%) had a high risk of bias.

Conclusion: The continued adoption of DOs remains uncertain because of concerns about the image quality for non-mydriatic eyes and the confidence in data captured from the device. Likewise, there is a lack of guidelines for the use of DOs, which makes it difficult for providers to determine the best device for their practice and to ensure appropriate use. Even so, DOs continue to gain acceptance as technology and practice integration improve, especially in underserved areas with limited access to ophthalmologists.

Keywords: diagnostics; fundoscopy; referral; screening; teleophthalmology.

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Conflict of interest statement

The authors declare that they have no conflicts of interest in this work.

Figures

Figure 1
Figure 1
PRISMA flow diagram illustrating the study selection process for the systematic review. *Records excluded after manual review by authors determined that studies were not relevant to the current review.
Figure 2
Figure 2
Representative retinal images of no apparent diabetic retinopathy (top left), mild nonproliferative diabetic retinopathy (top right), moderate nonproliferative diabetic retinopathy (bottom left), and panretinal photocoagulation scars in proliferative diabetic retinopathy (bottom right).
See this image and copyright information in PMC

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