Accuracy of Low-Cost, Smartphone-Based Retinal Photography for Diabetic Retinopathy Screening: A Systematic Review
Penulis/Author
dr. Mohammad Eko Prayogo, M.Med.Ed., Sp.M (1); ALFIA FATMA ZAHARO (2); NOVANDRIATI NUR R D (3); dr. Felicia Widyaputri, Ph.D. (4); Prof. dr. Jarir At Thobari, DPharm, Ph.D. (5); dr. Vina Yanti Susanti, M.Sc, Ph.D, SpPD, K-EMD (6); Prof. dr. Muhammad Bayu Sasongko, M.Epi, Ph.D., Sp.M (7)
Tanggal/Date
18 2023
Kata Kunci/Keyword
Abstrak/Abstract
Purpose: Diabetic retinopathy (DR) is a leading cause of blindness. Early DR screening is essential, but the infrastructure can be less
affordable in low resource countries. This study aims to review the accuracy of low-cost smartphone-based fundus cameras for DR
screening in adult patients with diabetes.
Methods: We performed a systematic literature search to find studies that reported the sensitivity and specificity of low-cost
smartphone-based devices for fundus photography in adult patients with diabetes. We searched three databases (MEDLINE, Google
Scholar, Scopus) and one register (Cochrane CENTRAL). We presented the accuracy values by grouping the diagnosis into three:
any DR, referrable DR, and diabetic macular oedema (DMO). Risk of bias and applicability of the studies were assessed using
QUADAS-2.
Results: Five out of 294 retrieved records were included with a total of six smartphone-based devices reviewed. All of the reference
diagnostic methods used in the included studies were either indirect ophthalmoscopy or slit-lamp examinations and all smartphonebased devices’ imaging protocols used mydriatic drops. The reported sensitivity and specificity for any DR were 52–92.2% and 73.3–
99%; for referral DR were 21–91.4% and 64.9–100%; and for DMO were 29.4–81% and 95–100%, respectively.
Conclusion: Sensitivity available low-cost smartphone-based devices for DR screening were acceptable and their specificity
particularly for detecting referrable DR and DMO were considerably good. These findings support their potential utilization for DR
screening in a low resources setting.
