1.Diagnostic accuracies of a Smartphone-Based Fundus photography and tablet-based visual field testing
Patricia Anne S. S. Tecson ; Victor Jose L. Caparas ; Rainier Victor A. Covar
Philippine Journal of Ophthalmology 2022;47(2):82-86
Objective:
We determined the diagnostic accuracies of the mydriatic, monoscopic, iPhone 6s+ optic nerve
photographs with a 20D lens and the Melbourne Rapid Fields (MRF) visual fields iPad application.
Methods:
This was a prospective, cross-sectional, single-center study involving 47 non-glaucomatous and 49
glaucomatous eyes. Each eye underwent 2 visual field tests: MRF iPad application and the Humphrey Field
Analyzer (HRF). Mydriatic photographs of the fundus were taken with two devices: an iPhone 6s+ combined
with a 20 D lens and the Visucam 500 fundus camera. All printouts were evaluated by 2 independent, masked
glaucoma specialists. Diagnostic accuracies between the modalities were computed. Agreements between
different parameters of both devices were analyzed using Cohen’s kappa test.
Results:
Smartphone-based (iPhone 6s+) fundus photos had an overall sensitivity of 100%, specificity of
89.36%, positive predictive value (PPV) of 89.36% and negative predictive value (NPV) of 100%, with all kappa
values between graders of each parameter above 0.61. Tablet-based Melbourne Rapid Fields test had a
sensitivity of 81.82%, specificity of 86.54%, PPV of 83.72% and NPV of 84.91%, showing good agreement
with the HRF with a kappa value of 0.68 ± 0.07.
Conclusion
Smartphone-based fundus photography and tablet-based visual field tests are comparable to the
standard fundus photos and visual field tests in evaluating the optic nerve and visual field. These portable
devices are reliable and appropriate tools for diagnosing glaucoma and can be used for documentation and
testing in remote areas and in a wider range of settings.
Fundus Oculi