Smartphone-based fundus photography for early detection of diabetic retinopathy in a tertiary care hospital: A prospective observational study

Background

To evaluate the diagnostic accuracy and grading concordance of smartphone-based non-mydriatic fundus photography (SFP) compared with slit-lamp biomicroscopic indirect ophthalmoscopy (BIO) for screening diabetic retinopathy (DR) in a hospital-based diabetic population in India. Materials and Methods: In this prospective observational study conducted over 12 months at a tertiary-care teaching hospital of NMCH, we enrolled 186 consecutive patients with type 2 diabetes mellitus (T2DM). Each patient underwent SFP using a portable smartphone-based fundus imaging device followed by standard 90-diopter slit-lamp BIO by a masked retinal specialist. DR was graded using the International Clinical Diabetic Retinopathy (ICDR) Disease Severity Scale. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and weighted kappa (κ) were computed with BIO as the reference standard.