According to the WHO, Glaucoma can be defined as a “group of diseases that have as a common end-point a characteristic optic neuropathy which is determined by both structural change and functional deficit. […] There are several types of glaucoma, however, the two most common are primary open angle glaucoma (POAG), having a slow and insidious onset, and angle closure glaucoma (ACG), which is less common and tends to be more acute.”
4.5 million people are estimated to be blind as a result of primary glaucoma, approximately the 12% of all global blindness.
Glaucoma affects approximately the 10% of people over 60 years old
Glaucoma recorded with the D-EYE
Example of Glaucoma recorded with the
D-EYE Smartphone-Based Retinal Imaging System
Example of Glaucoma recorded with the D-EYE Smerphone-Based Retinal Imaging System
How to perform a retinal examination
The application allows users to capture images of the optic disc of non-mydriatic eyes. It can be used for Glaucoma screenings without dilation drops. Dilation drops will be required to increase field of view (FOV) to see more retinal structure that would include the observation of AMD and mild non-proliferative retinopathy.
Using the video function will capture maximum retinal structure regardless of dilation. The auto focus function is set for 1cm of distance from the pupil. If the lens is too far away, the results of the exam will not be in focus and the pupil will appear very small. An examination of a non-mydriatic pupil will result in the view of the optic disc and partial retinal structure around the disc. More structure can be seen with a mydriatic pupil. With the optic disc centered, the acquisition protocol would be to pan the retina, starting from the posterior pole and then moving to the upper, nasal, inferior, and nasal peripheral retina to the equator. This exam protocol encompasses the posterior pole, including the macula, optic disc, and peripheral retina.
Many papers have been published about D-EYE. One of these was published in the Journal of Glaucoma in September 2016
(1)Russo, Andrea MD; Mapham, William MD; Turano, Raffaele MD; Costagliola, Ciro MD; Morescalchi, Francesco MD; Scaroni, Nicolò MD; Semeraro, Francesco MD. (2016). Comparison of Smartphone Ophthalmoscopy With Slit-Lamp Biomicroscopy for Grading Vertical Cup-to-Disc Ratio. Journal of Glaucoma, 25(9), 777-781.
As indicated in the September 2016 issue of the Journal of Glaucoma, a study was performed to determine the agreement between D-EYE Smartphone-Based Retinal Ophthalmoscopy and Slit-Lamp Indirect Biomicroscopy when assessing vertical cup-to-disc ratios. 110 undilated patients participated in the study, some with ocular hypertension and others with primary open angle glaucoma.
The study concluded that D-EYE showed substantial agreement with slit-lamp examination for the estimation of the Vertical Cup-to-Disc Ratio (VCDR).
“The ubiquitous diffusion of the smartphones, together with their connectivity and portability features, enables an extensive benefit for this technology to be used in glaucoma screening, especially in low-resource settings.”