The Experts below are selected from a list of 324 Experts worldwide ranked by ideXlab platform
Valérie Biousse - One of the best experts on this subject based on the ideXlab platform.
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Ophthalmoscopy in the 21st century the 2017 h houston merritt lecture
Neurology, 2017Co-Authors: Valérie Biousse, Beau B. Bruce, Nancy J. NewmanAbstract:Although the usefulness of viewing the ocular fundus is well-recognized, Ophthalmoscopy is infrequently and poorly performed by most nonophthalmologist physicians, including neurologists. Barriers to the practice of Ophthalmoscopy by nonophthalmologists include not only the technical difficulty related to direct Ophthalmoscopy, but also lack of adequate training and discouragement by preceptors. Recent studies have shown that digital retinal fundus photographs with electronic transmission and remote interpretation of images by an ophthalmologist are an efficient and reliable way to allow examination of the ocular fundus in patients with systemic disorders such as diabetes mellitus. Ocular fundus photographs obtained without pharmacologic dilation of the pupil using nonmydriatic fundus cameras could be of great value in emergency departments (EDs) and neurologic settings. The Fundus Photography vs Ophthalmoscopy Trial Outcomes in the Emergency Department (FOTO-ED) study showed that ED providers consistently failed to correctly identify relevant ocular funduscopic findings using the direct ophthalmoscope, and that nonmydriatic fundus photography was an effective alternate way of providing access to the ocular fundus in the ED. Extrapolating these results to headache clinics, outpatient neurology clinics, and adult and pediatric primary care settings seems self-evident. As technology advances, nonmydriatic ocular fundus imaging systems will be of higher quality and more portable and affordable, thereby circumventing the need to master the use of the ophthalmoscope. Visualizing the ocular fundus is more important than the method used. Ocular fundus photography facilitates nonophthalmologists9 performance of this essential part of the physical examination, thus helping to reestablish the value of doing so.
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the demise of direct Ophthalmoscopy a modern clinical challenge
PMC, 2015Co-Authors: Devin D. Mackay, Philip S. Garza, Beau B. Bruce, Nancy J. Newman, Valérie BiousseAbstract:Ocular funduscopy appears to be a dying art. Physicians and medical students alike lack confidence in the use of an ophthalmoscope. As a result, few clinicians perform Ophthalmoscopy, and many who do are unable to reliably detect abnormalities of the ocular fundus. Approaches to remediation in undergraduate medical education have included simulators, longitudinal skill reinforcement, Web-based teaching, and other techniques. Preservation of the ophthalmoscopic art has been hindered by technical difficulty, waning enthusiasm for Ophthalmoscopy, and even discouragement from preceptors in medical education. Ocular fundus photography may serve a role in medical education to help improve student confidence in interpretation of ocular fundus findings and improve awareness of the importance of examination of the ocular fundus. Because neurology clerkships and clinical practices remain an important forum for honing ocular funduscopy skills, the neurologist should be familiar with novel alternative techniques that facilitate examination of the ocular fundus.
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Teaching Ophthalmoscopy to Medical Students (TOTeMS) II: A One-Year Retention Study (P1.325)
Neurology, 2014Co-Authors: Devin D. Mackay, Philip S. Garza, Beau B. Bruce, Samuel Bidot, Linda P. Kelly, Emily B. Graubart, Nancy J. Newman, Valérie BiousseAbstract:OBJECTIVE: We previously demonstrated that medical students (MS) performed more accurately and preferred using photographs than direct Ophthalmoscopy to examine the ocular fundus. We hypothesized that these differences would persist over time. BACKGROUND: Learning direct Ophthalmoscopy is challenging, and MS long-term retention of Ophthalmoscopy skills is poor. DESIGN/METHODS: One year after initial training, second-year MS were randomized and reevaluated on their ability to examine the ocular fundus using either fundus photographs or direct Ophthalmoscopy on eye simulators. Positive and negative affect, preferences, and clinical experiences with ocular fundus examination were assessed. RESULTS: 107/119 students (90%) who participated in the original study completed this one-year retention study. Students answered 34/48 (71%) questions correctly using photographs and 31/48 (65%) correctly using Ophthalmoscopy (p
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teaching Ophthalmoscopy to medical students the totems study
American Journal of Ophthalmology, 2013Co-Authors: Linda P. Kelly, Philip S. Garza, Beau B. Bruce, Emily B. Graubart, Nancy J. Newman, Valérie BiousseAbstract:Purpose To determine medical student preferences for learning the ocular fundus examination and to assess their accuracy using different examination modalities. Design Prospective, randomized study of medical student education approaches. Methods First-year medical students received training in direct Ophthalmoscopy using simulators and human volunteers. Students were randomized to receive vs not receive specific training on interpreting fundus photographs prior to accuracy assessments. Students' preferences for each of the 3 methods (direct Ophthalmoscopy on simulators or human volunteers, or use of fundus photographs) and recognition of normal and abnormal fundus features were assessed. Results Of 138 first-year medical students, 119 (86%) completed all required elements. For learning Ophthalmoscopy, 85 (71%) preferred humans to simulators. For learning relevant features of the ocular fundus, 92 (77%) preferred photographs to Ophthalmoscopy on simulators or humans. Accuracy of answers was better when interpreting fundus photographs than when performing Ophthalmoscopy on simulators ( P P = .02). Examination of the ocular fundus was found easier and less frustrating when using photographs than when using Ophthalmoscopy on simulators or humans. Eighty-four students (70%) said they would prefer to have fundus photographs instead of using the ophthalmoscope during upcoming clinical rotations. Conclusions Students preferred fundus photographs for both learning and examining the ocular fundus. Identification of ocular fundus features was more accurate on photographs compared to examination by direct Ophthalmoscopy. In the future, the increasing availability of nonmydriatic ocular fundus photography may allow replacement of direct Ophthalmoscopy in many clinical settings for non-ophthalmologists.
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nonmydriatic ocular fundus photography in the emergency department
The New England Journal of Medicine, 2011Co-Authors: Beau B. Bruce, Valérie Biousse, Cedric Lamirel, David W Wright, Antionette Ward, Kate L Heilpern, Nancy J. NewmanAbstract:To the Editor: Examination of the ocular fundus is imperative in the diagnosis and treatment of many acute medical and neurologic conditions, but direct Ophthalmoscopy is underused and difficult to perform without pharmacologic pupillary dilation.1,2 We believe that nonmydriatic ocular fundus photography (i.e., performed without pupillary dilation) represents a promising alternative to direct Ophthalmoscopy, particularly in the emergency department, where limited training in Ophthalmoscopy, increased demands on physicians' time, and underappreciation of the prognostic value of ocular fundus examination can place patients at risk for poor outcomes and expose their caregivers to medicolegal liability.1,3 The FOTO-ED (Fundus Photography . . .
Francesco Semeraro - One of the best experts on this subject based on the ideXlab platform.
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Research Article A Novel Device to Exploit the Smartphone Camera for Fundus Photography
2016Co-Authors: Andrea Russo, Francesco Morescalchi, Luisa Delcassi, Ciro Costagliola, Francesco SemeraroAbstract:which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Purpose. To construct an inexpensive, convenient, and portable attachment for smartphones for the acquisition of still and live retinal images.Methods. A small optical device based on the principle of direct Ophthalmoscopy was designed to be magnetically attached to a smartphone. Representative images of normal and pathological fundi were taken with the device. Results. A field-of-view up to ∼20 ∘ was captured at a clinical resolution for each fundus image. The cross-polarization technique adopted in the optical design dramatically diminished corneal Purkinje reflections, making it possible to screen patients even through undilated pupils. Light emission proved to be well within safety limits. Conclusions. This optical attachment is a promising, inexpensive, and valuable alternative to the direct ophthalmoscope, potentially eliminating problems of poor exam skills and inexperienced observer bias. Its portability, together with the wireless connectivity of smartphones, presents a promising platform for screening and telemedicine in nonhospital settings. Translational Relevance. Smartphones have the potential to acquire retinal imaging for a portable Ophthalmoscopy. 1
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a novel device to exploit the smartphone camera for fundus photography
Journal of Ophthalmology, 2015Co-Authors: Andrea Russo, Francesco Morescalchi, Luisa Delcassi, Ciro Costagliola, Francesco SemeraroAbstract:Purpose. To construct an inexpensive, convenient, and portable attachment for smartphones for the acquisition of still and live retinal images. Methods. A small optical device based on the principle of direct Ophthalmoscopy was designed to be magnetically attached to a smartphone. Representative images of normal and pathological fundi were taken with the device. Results. A field-of-view up to ~20° was captured at a clinical resolution for each fundus image. The cross-polarization technique adopted in the optical design dramatically diminished corneal Purkinje reflections, making it possible to screen patients even through undilated pupils. Light emission proved to be well within safety limits. Conclusions. This optical attachment is a promising, inexpensive, and valuable alternative to the direct ophthalmoscope, potentially eliminating problems of poor exam skills and inexperienced observer bias. Its portability, together with the wireless connectivity of smartphones, presents a promising platform for screening and telemedicine in nonhospital settings. Translational Relevance. Smartphones have the potential to acquire retinal imaging for a portable Ophthalmoscopy.
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comparison of smartphone Ophthalmoscopy with slit lamp biomicroscopy for grading diabetic retinopathy
American Journal of Ophthalmology, 2015Co-Authors: Andrea Russo, Francesco Morescalchi, Luisa Delcassi, Ciro Costagliola, Francesco SemeraroAbstract:Purpose To assess the accuracy and reliability of smartphone Ophthalmoscopy, we compared the ability of a smartphone ophthalmoscope with that of a slit-lamp biomicroscope to grade diabetic retinopathy (DR) in patients with diabetes mellitus (DM). Design Clinical-based, prospective, comparative instrument study. Methods This comparative clinical study was performed in 120 outpatients (240 eyes) with type 1 or type 2 DM. After pupil dilation, the patients underwent smartphone Ophthalmoscopy with the D-Eye device, followed by dilated retinal slit-lamp examination, to grade DR according to a 5-step scale. Results Overall exact agreement between the 2 methods was observed in 204 of 240 eyes (85%) (simple κ = 0.78; CI 0.71-0.84) and agreement within 1 step was observed in 232 eyes (96.7%). Compared to biomicroscopy, the sensitivity and specificity of smartphone Ophthalmoscopy for the detection of clinically significant macular edema were 81% and 98%, respectively. Smartphone Ophthalmoscopy and biomicroscopy could not be used to examine the fundus and grade DR in 9 eyes (3.75%) and 4 eyes (1.7%), respectively, because of cataract and/or small pupil diameter. Conclusion Smartphone Ophthalmoscopy showed considerable agreement with dilated retinal biomicroscopy for the grading of DR. The portability, affordability, and connectivity of a smartphone ophthalmoscope make smartphone Ophthalmoscopy a promising technique for community screening programs.
Nancy J. Newman - One of the best experts on this subject based on the ideXlab platform.
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Ophthalmoscopy in the 21st century the 2017 h houston merritt lecture
Neurology, 2017Co-Authors: Valérie Biousse, Beau B. Bruce, Nancy J. NewmanAbstract:Although the usefulness of viewing the ocular fundus is well-recognized, Ophthalmoscopy is infrequently and poorly performed by most nonophthalmologist physicians, including neurologists. Barriers to the practice of Ophthalmoscopy by nonophthalmologists include not only the technical difficulty related to direct Ophthalmoscopy, but also lack of adequate training and discouragement by preceptors. Recent studies have shown that digital retinal fundus photographs with electronic transmission and remote interpretation of images by an ophthalmologist are an efficient and reliable way to allow examination of the ocular fundus in patients with systemic disorders such as diabetes mellitus. Ocular fundus photographs obtained without pharmacologic dilation of the pupil using nonmydriatic fundus cameras could be of great value in emergency departments (EDs) and neurologic settings. The Fundus Photography vs Ophthalmoscopy Trial Outcomes in the Emergency Department (FOTO-ED) study showed that ED providers consistently failed to correctly identify relevant ocular funduscopic findings using the direct ophthalmoscope, and that nonmydriatic fundus photography was an effective alternate way of providing access to the ocular fundus in the ED. Extrapolating these results to headache clinics, outpatient neurology clinics, and adult and pediatric primary care settings seems self-evident. As technology advances, nonmydriatic ocular fundus imaging systems will be of higher quality and more portable and affordable, thereby circumventing the need to master the use of the ophthalmoscope. Visualizing the ocular fundus is more important than the method used. Ocular fundus photography facilitates nonophthalmologists9 performance of this essential part of the physical examination, thus helping to reestablish the value of doing so.
-
the demise of direct Ophthalmoscopy a modern clinical challenge
PMC, 2015Co-Authors: Devin D. Mackay, Philip S. Garza, Beau B. Bruce, Nancy J. Newman, Valérie BiousseAbstract:Ocular funduscopy appears to be a dying art. Physicians and medical students alike lack confidence in the use of an ophthalmoscope. As a result, few clinicians perform Ophthalmoscopy, and many who do are unable to reliably detect abnormalities of the ocular fundus. Approaches to remediation in undergraduate medical education have included simulators, longitudinal skill reinforcement, Web-based teaching, and other techniques. Preservation of the ophthalmoscopic art has been hindered by technical difficulty, waning enthusiasm for Ophthalmoscopy, and even discouragement from preceptors in medical education. Ocular fundus photography may serve a role in medical education to help improve student confidence in interpretation of ocular fundus findings and improve awareness of the importance of examination of the ocular fundus. Because neurology clerkships and clinical practices remain an important forum for honing ocular funduscopy skills, the neurologist should be familiar with novel alternative techniques that facilitate examination of the ocular fundus.
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Teaching Ophthalmoscopy to Medical Students (TOTeMS) II: A One-Year Retention Study (P1.325)
Neurology, 2014Co-Authors: Devin D. Mackay, Philip S. Garza, Beau B. Bruce, Samuel Bidot, Linda P. Kelly, Emily B. Graubart, Nancy J. Newman, Valérie BiousseAbstract:OBJECTIVE: We previously demonstrated that medical students (MS) performed more accurately and preferred using photographs than direct Ophthalmoscopy to examine the ocular fundus. We hypothesized that these differences would persist over time. BACKGROUND: Learning direct Ophthalmoscopy is challenging, and MS long-term retention of Ophthalmoscopy skills is poor. DESIGN/METHODS: One year after initial training, second-year MS were randomized and reevaluated on their ability to examine the ocular fundus using either fundus photographs or direct Ophthalmoscopy on eye simulators. Positive and negative affect, preferences, and clinical experiences with ocular fundus examination were assessed. RESULTS: 107/119 students (90%) who participated in the original study completed this one-year retention study. Students answered 34/48 (71%) questions correctly using photographs and 31/48 (65%) correctly using Ophthalmoscopy (p
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teaching Ophthalmoscopy to medical students the totems study
American Journal of Ophthalmology, 2013Co-Authors: Linda P. Kelly, Philip S. Garza, Beau B. Bruce, Emily B. Graubart, Nancy J. Newman, Valérie BiousseAbstract:Purpose To determine medical student preferences for learning the ocular fundus examination and to assess their accuracy using different examination modalities. Design Prospective, randomized study of medical student education approaches. Methods First-year medical students received training in direct Ophthalmoscopy using simulators and human volunteers. Students were randomized to receive vs not receive specific training on interpreting fundus photographs prior to accuracy assessments. Students' preferences for each of the 3 methods (direct Ophthalmoscopy on simulators or human volunteers, or use of fundus photographs) and recognition of normal and abnormal fundus features were assessed. Results Of 138 first-year medical students, 119 (86%) completed all required elements. For learning Ophthalmoscopy, 85 (71%) preferred humans to simulators. For learning relevant features of the ocular fundus, 92 (77%) preferred photographs to Ophthalmoscopy on simulators or humans. Accuracy of answers was better when interpreting fundus photographs than when performing Ophthalmoscopy on simulators ( P P = .02). Examination of the ocular fundus was found easier and less frustrating when using photographs than when using Ophthalmoscopy on simulators or humans. Eighty-four students (70%) said they would prefer to have fundus photographs instead of using the ophthalmoscope during upcoming clinical rotations. Conclusions Students preferred fundus photographs for both learning and examining the ocular fundus. Identification of ocular fundus features was more accurate on photographs compared to examination by direct Ophthalmoscopy. In the future, the increasing availability of nonmydriatic ocular fundus photography may allow replacement of direct Ophthalmoscopy in many clinical settings for non-ophthalmologists.
-
nonmydriatic ocular fundus photography in the emergency department
The New England Journal of Medicine, 2011Co-Authors: Beau B. Bruce, Valérie Biousse, Cedric Lamirel, David W Wright, Antionette Ward, Kate L Heilpern, Nancy J. NewmanAbstract:To the Editor: Examination of the ocular fundus is imperative in the diagnosis and treatment of many acute medical and neurologic conditions, but direct Ophthalmoscopy is underused and difficult to perform without pharmacologic pupillary dilation.1,2 We believe that nonmydriatic ocular fundus photography (i.e., performed without pupillary dilation) represents a promising alternative to direct Ophthalmoscopy, particularly in the emergency department, where limited training in Ophthalmoscopy, increased demands on physicians' time, and underappreciation of the prognostic value of ocular fundus examination can place patients at risk for poor outcomes and expose their caregivers to medicolegal liability.1,3 The FOTO-ED (Fundus Photography . . .
Beau B. Bruce - One of the best experts on this subject based on the ideXlab platform.
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Ophthalmoscopy in the 21st century the 2017 h houston merritt lecture
Neurology, 2017Co-Authors: Valérie Biousse, Beau B. Bruce, Nancy J. NewmanAbstract:Although the usefulness of viewing the ocular fundus is well-recognized, Ophthalmoscopy is infrequently and poorly performed by most nonophthalmologist physicians, including neurologists. Barriers to the practice of Ophthalmoscopy by nonophthalmologists include not only the technical difficulty related to direct Ophthalmoscopy, but also lack of adequate training and discouragement by preceptors. Recent studies have shown that digital retinal fundus photographs with electronic transmission and remote interpretation of images by an ophthalmologist are an efficient and reliable way to allow examination of the ocular fundus in patients with systemic disorders such as diabetes mellitus. Ocular fundus photographs obtained without pharmacologic dilation of the pupil using nonmydriatic fundus cameras could be of great value in emergency departments (EDs) and neurologic settings. The Fundus Photography vs Ophthalmoscopy Trial Outcomes in the Emergency Department (FOTO-ED) study showed that ED providers consistently failed to correctly identify relevant ocular funduscopic findings using the direct ophthalmoscope, and that nonmydriatic fundus photography was an effective alternate way of providing access to the ocular fundus in the ED. Extrapolating these results to headache clinics, outpatient neurology clinics, and adult and pediatric primary care settings seems self-evident. As technology advances, nonmydriatic ocular fundus imaging systems will be of higher quality and more portable and affordable, thereby circumventing the need to master the use of the ophthalmoscope. Visualizing the ocular fundus is more important than the method used. Ocular fundus photography facilitates nonophthalmologists9 performance of this essential part of the physical examination, thus helping to reestablish the value of doing so.
-
the demise of direct Ophthalmoscopy a modern clinical challenge
PMC, 2015Co-Authors: Devin D. Mackay, Philip S. Garza, Beau B. Bruce, Nancy J. Newman, Valérie BiousseAbstract:Ocular funduscopy appears to be a dying art. Physicians and medical students alike lack confidence in the use of an ophthalmoscope. As a result, few clinicians perform Ophthalmoscopy, and many who do are unable to reliably detect abnormalities of the ocular fundus. Approaches to remediation in undergraduate medical education have included simulators, longitudinal skill reinforcement, Web-based teaching, and other techniques. Preservation of the ophthalmoscopic art has been hindered by technical difficulty, waning enthusiasm for Ophthalmoscopy, and even discouragement from preceptors in medical education. Ocular fundus photography may serve a role in medical education to help improve student confidence in interpretation of ocular fundus findings and improve awareness of the importance of examination of the ocular fundus. Because neurology clerkships and clinical practices remain an important forum for honing ocular funduscopy skills, the neurologist should be familiar with novel alternative techniques that facilitate examination of the ocular fundus.
-
Teaching Ophthalmoscopy to Medical Students (TOTeMS) II: A One-Year Retention Study (P1.325)
Neurology, 2014Co-Authors: Devin D. Mackay, Philip S. Garza, Beau B. Bruce, Samuel Bidot, Linda P. Kelly, Emily B. Graubart, Nancy J. Newman, Valérie BiousseAbstract:OBJECTIVE: We previously demonstrated that medical students (MS) performed more accurately and preferred using photographs than direct Ophthalmoscopy to examine the ocular fundus. We hypothesized that these differences would persist over time. BACKGROUND: Learning direct Ophthalmoscopy is challenging, and MS long-term retention of Ophthalmoscopy skills is poor. DESIGN/METHODS: One year after initial training, second-year MS were randomized and reevaluated on their ability to examine the ocular fundus using either fundus photographs or direct Ophthalmoscopy on eye simulators. Positive and negative affect, preferences, and clinical experiences with ocular fundus examination were assessed. RESULTS: 107/119 students (90%) who participated in the original study completed this one-year retention study. Students answered 34/48 (71%) questions correctly using photographs and 31/48 (65%) correctly using Ophthalmoscopy (p
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teaching Ophthalmoscopy to medical students the totems study
American Journal of Ophthalmology, 2013Co-Authors: Linda P. Kelly, Philip S. Garza, Beau B. Bruce, Emily B. Graubart, Nancy J. Newman, Valérie BiousseAbstract:Purpose To determine medical student preferences for learning the ocular fundus examination and to assess their accuracy using different examination modalities. Design Prospective, randomized study of medical student education approaches. Methods First-year medical students received training in direct Ophthalmoscopy using simulators and human volunteers. Students were randomized to receive vs not receive specific training on interpreting fundus photographs prior to accuracy assessments. Students' preferences for each of the 3 methods (direct Ophthalmoscopy on simulators or human volunteers, or use of fundus photographs) and recognition of normal and abnormal fundus features were assessed. Results Of 138 first-year medical students, 119 (86%) completed all required elements. For learning Ophthalmoscopy, 85 (71%) preferred humans to simulators. For learning relevant features of the ocular fundus, 92 (77%) preferred photographs to Ophthalmoscopy on simulators or humans. Accuracy of answers was better when interpreting fundus photographs than when performing Ophthalmoscopy on simulators ( P P = .02). Examination of the ocular fundus was found easier and less frustrating when using photographs than when using Ophthalmoscopy on simulators or humans. Eighty-four students (70%) said they would prefer to have fundus photographs instead of using the ophthalmoscope during upcoming clinical rotations. Conclusions Students preferred fundus photographs for both learning and examining the ocular fundus. Identification of ocular fundus features was more accurate on photographs compared to examination by direct Ophthalmoscopy. In the future, the increasing availability of nonmydriatic ocular fundus photography may allow replacement of direct Ophthalmoscopy in many clinical settings for non-ophthalmologists.
-
nonmydriatic ocular fundus photography in the emergency department
The New England Journal of Medicine, 2011Co-Authors: Beau B. Bruce, Valérie Biousse, Cedric Lamirel, David W Wright, Antionette Ward, Kate L Heilpern, Nancy J. NewmanAbstract:To the Editor: Examination of the ocular fundus is imperative in the diagnosis and treatment of many acute medical and neurologic conditions, but direct Ophthalmoscopy is underused and difficult to perform without pharmacologic pupillary dilation.1,2 We believe that nonmydriatic ocular fundus photography (i.e., performed without pupillary dilation) represents a promising alternative to direct Ophthalmoscopy, particularly in the emergency department, where limited training in Ophthalmoscopy, increased demands on physicians' time, and underappreciation of the prognostic value of ocular fundus examination can place patients at risk for poor outcomes and expose their caregivers to medicolegal liability.1,3 The FOTO-ED (Fundus Photography . . .
Andrea Russo - One of the best experts on this subject based on the ideXlab platform.
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Research Article A Novel Device to Exploit the Smartphone Camera for Fundus Photography
2016Co-Authors: Andrea Russo, Francesco Morescalchi, Luisa Delcassi, Ciro Costagliola, Francesco SemeraroAbstract:which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Purpose. To construct an inexpensive, convenient, and portable attachment for smartphones for the acquisition of still and live retinal images.Methods. A small optical device based on the principle of direct Ophthalmoscopy was designed to be magnetically attached to a smartphone. Representative images of normal and pathological fundi were taken with the device. Results. A field-of-view up to ∼20 ∘ was captured at a clinical resolution for each fundus image. The cross-polarization technique adopted in the optical design dramatically diminished corneal Purkinje reflections, making it possible to screen patients even through undilated pupils. Light emission proved to be well within safety limits. Conclusions. This optical attachment is a promising, inexpensive, and valuable alternative to the direct ophthalmoscope, potentially eliminating problems of poor exam skills and inexperienced observer bias. Its portability, together with the wireless connectivity of smartphones, presents a promising platform for screening and telemedicine in nonhospital settings. Translational Relevance. Smartphones have the potential to acquire retinal imaging for a portable Ophthalmoscopy. 1
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a novel device to exploit the smartphone camera for fundus photography
Journal of Ophthalmology, 2015Co-Authors: Andrea Russo, Francesco Morescalchi, Luisa Delcassi, Ciro Costagliola, Francesco SemeraroAbstract:Purpose. To construct an inexpensive, convenient, and portable attachment for smartphones for the acquisition of still and live retinal images. Methods. A small optical device based on the principle of direct Ophthalmoscopy was designed to be magnetically attached to a smartphone. Representative images of normal and pathological fundi were taken with the device. Results. A field-of-view up to ~20° was captured at a clinical resolution for each fundus image. The cross-polarization technique adopted in the optical design dramatically diminished corneal Purkinje reflections, making it possible to screen patients even through undilated pupils. Light emission proved to be well within safety limits. Conclusions. This optical attachment is a promising, inexpensive, and valuable alternative to the direct ophthalmoscope, potentially eliminating problems of poor exam skills and inexperienced observer bias. Its portability, together with the wireless connectivity of smartphones, presents a promising platform for screening and telemedicine in nonhospital settings. Translational Relevance. Smartphones have the potential to acquire retinal imaging for a portable Ophthalmoscopy.
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comparison of smartphone Ophthalmoscopy with slit lamp biomicroscopy for grading diabetic retinopathy
American Journal of Ophthalmology, 2015Co-Authors: Andrea Russo, Francesco Morescalchi, Luisa Delcassi, Ciro Costagliola, Francesco SemeraroAbstract:Purpose To assess the accuracy and reliability of smartphone Ophthalmoscopy, we compared the ability of a smartphone ophthalmoscope with that of a slit-lamp biomicroscope to grade diabetic retinopathy (DR) in patients with diabetes mellitus (DM). Design Clinical-based, prospective, comparative instrument study. Methods This comparative clinical study was performed in 120 outpatients (240 eyes) with type 1 or type 2 DM. After pupil dilation, the patients underwent smartphone Ophthalmoscopy with the D-Eye device, followed by dilated retinal slit-lamp examination, to grade DR according to a 5-step scale. Results Overall exact agreement between the 2 methods was observed in 204 of 240 eyes (85%) (simple κ = 0.78; CI 0.71-0.84) and agreement within 1 step was observed in 232 eyes (96.7%). Compared to biomicroscopy, the sensitivity and specificity of smartphone Ophthalmoscopy for the detection of clinically significant macular edema were 81% and 98%, respectively. Smartphone Ophthalmoscopy and biomicroscopy could not be used to examine the fundus and grade DR in 9 eyes (3.75%) and 4 eyes (1.7%), respectively, because of cataract and/or small pupil diameter. Conclusion Smartphone Ophthalmoscopy showed considerable agreement with dilated retinal biomicroscopy for the grading of DR. The portability, affordability, and connectivity of a smartphone ophthalmoscope make smartphone Ophthalmoscopy a promising technique for community screening programs.