Feasibility and clinical utility of handheld fundus cameras for retinal imaging

Background/objectives Handheld fundus cameras are portable and cheaper alternatives to table-top counterparts. To date there have been no studies comparing feasibility and clinical utility of handheld fundus cameras to table-top devices. We compare the feasibility and clinical utility of four handheld fundus cameras (Remidio NMFOP, Volk Pictor Plus, Volk iNview, oDocs visoScope) to a table-top camera (Zeiss Visucam(NM/FA)). Subjects/methods Healthy participants (n = 10, mean age +/- SD = 21.0 +/- 0.9 years) underwent fundus photography with five fundus cameras to assess success/failure rates of image acquisition. Participants with optic disc abnormalities (n = 8, mean age +/- SD = 26.8 +/- 15.9) and macular abnormalities (n = 10, mean age +/- SD = 71.6 +/- 15.4) underwent imaging with the top three scoring fundus cameras. Images were randomised and subsequently validated by ophthalmologists masked to the diagnoses and devices used. Results Image acquisition success rates (100%) were achieved in non-mydriatic and mydriatic settings for Zeiss, Remidio and Pictor, compared with lower success rates for iNview and oDocs. Image quality and gradeability were significantly higher for Zeiss, Remidio and Pictor (p < 0.0001) compared to iNview and oDocs. For cup:disc ratio estimates, similar levels of bias were seen for Zeiss (-0.09 +/- SD:0.15), Remidio (-0.07 +/- SD:0.14) and Pictor (-0.05 +/- SD:0.16). Diagnostic sensitivities were highest for Zeiss (84.9%; 95% CI, 78.2-91.5%) followed by Pictor (78.1%; 95% CI, 66.6-89.5%) and Remidio (77.5%; 95% CI, 65.9-89.0%). Conclusions Remidio and Pictor achieve comparable results to the Zeiss table-top camera. Both devices achieved similar scores in feasibility, image quality, image gradeability and diagnostic sensitivity. This suggests that these devices potentially offer a more cost-effective alternative in certain clinical scenarios.

Automated summary

This study compared the feasibility and clinical utility of five fundus cameras. The results showed that Remidio and Pictor achieved comparable results to the Zeiss table-top camera, while iNview and oDocs had lower performance. Zeiss performed best in cup:disc ratio estimates and diagnostic sensitivity. Therefore, Remidio and Pictor may be more cost-effective alternatives in certain clinical scenarios.