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   Table of Contents      
LETTER TO THE EDITOR
Year : 2019  |  Volume : 67  |  Issue : 11  |  Page : 1909

Smartphone-based fundus documentation in retinopathy of prematurity


1 Department of Vitreoretinal Surgery, Dr. NSD Raju's Eye Hospital and Research Center, Kochi, Kerala, India
2 Department of Cataract and Anterior Segment Surgeries, Dr. NSD Raju's Eye Hospital and Research Center, Kochi, Kerala, India
3 Department of Glaucoma, Little Flower Institute of Ophthalmology, Angamaly, Kerala, India
4 Department of Vitreoretinal and Uveitis Services, L V Prasad Eye Institute, Visakhapatanam, Andhra Pradesh, India

Date of Web Publication22-Oct-2019

Correspondence Address:
Dr. Biju Raju
Dr. NSD Raju's Eye Hospital and Research Center, Vyttila, Kochi - 682 019, Kerala
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijo.IJO_1080_19

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How to cite this article:
Raju B, Raju N S, Akkara JD, Pathengay A. Smartphone-based fundus documentation in retinopathy of prematurity. Indian J Ophthalmol 2019;67:1909

How to cite this URL:
Raju B, Raju N S, Akkara JD, Pathengay A. Smartphone-based fundus documentation in retinopathy of prematurity. Indian J Ophthalmol [serial online] 2019 [cited 2019 Nov 18];67:1909. Available from: http://www.ijo.in/text.asp?2019/67/11/1909/269598



We read with interest the article “Smartphone-guided wide-field imaging for retinopathy of prematurity in neonatal intensive care unit – A Smart ROP (SROP) initiative.”[1]

As we described in 2015, smartphones can be used effectively in the screening of retinopathy of prematurity (ROP).[2] The concept of the one-handed technique was described by Sharma A et al.[3] We also described the use of DIYretCAM as a cost-effective smartphone imaging technique for the peripheral retina using the one-handed technique with simultaneous scleral depression, and for the first time, smartphone-based stereoscopic imaging ROP[4] demonstrated once again in this stereo pair of stage 3 ROP [Figure 1]. The following suggestions can make the technique better:
Figure 1: Stereoscopic pair (parallel view) showing stage 3 ROP

Click here to view


  1. Using the manual focus mode during the video capture gives images that are focused much better than that taken with the autofocus mode. The manual focus mode is available in recent apps like HopeScope (https://itunes.apple.com/us/app/hopescope/id1331409701?ls=1 and mt=8) and Ullman Indirect app (https://itunes.apple.com/us/app/ullman-indirect/id1243282866?mt=8).
  2. A 20D condensing lens gives a magnified image, and with simultaneous scleral depression, excellent images of the periphery can be captured.
  3. Cross polarization with a pair of polarizers placed perpendicular to each other, with one placed over the flash of the phone and other oriented 90° opposite to the former over the camera, will help eliminate the Purkinje images or reflection artifacts from the lens, to a large extent. But cross polarization has a disadvantage of lowering the overall exposure of the image. With newer phone cameras having good low light sensitivity, excellent images can be captured even with cross polarization as demonstrated in the video showing popcorn lesions in ROP [Video Clip 1].





We congratulate the authors for this well-done study which strongly supports our initial observations.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Goyal A, Gopalakrishnan M, Anantharaman G, Chandrashekharan DP, Thachil T, Sharma A. Smartphone guided wide-field imaging for retinopathy of prematurity in neonatal intensive care unit – A Smart ROP (SROP) initiative. Indian J Ophthalmol 2019;67:840-5.  Back to cited text no. 1
[PUBMED]  [Full text]  
2.
Raju B, Raju N. Regarding fundus imaging with a mobile phone: A review of techniques. Indian J Ophthalmol 2015;63:170-1.  Back to cited text no. 2
[PUBMED]  [Full text]  
3.
Sharma A, Subramaniam SD, Ramachandran KI, Lakshmikanthan C, Krishna S, Sundaramoorthy SK. Smartphone-based fundus camera device (MII Ret Cam) and technique with ability to image peripheral retina. Eur J Ophthalmol 2016;26:142-4.  Back to cited text no. 3
    
4.
Raju B, Raju N, Akkara JD, Pathengay A. Do it yourself smartphone fundus camera – DIYretCAM. Indian J Ophthalmol 2016;64:663-7.  Back to cited text no. 4
[PUBMED]  [Full text]  


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