Agreement between retinal images obtained via smartphones and images obtained with retinal cameras or fundoscopic exams – systematic review and meta-analysis

Abstract

Background: Smartphone fundoscopy is a new option for visualizing the ocular fundus but must be validated before being included in population-based examinations. Our aim was to evaluate the quality of fundoscopic images obtained via smartphone and to compare their agreement with retinal camera images or clinical examination. Methods: The database for this study included all observational studies with smartphone fundoscopy that have comparative analyses with the gold standard methods. Results: Out of 121 potentially relevant studies, nine were included in this analysis, compris- ing a total of 4,219 eyes. Mean age was 56.6 years (SD±8.5). Combined kappa (κ) agreement statistics were equal to 77.77% (95% CI: 70.34%, 83.70%). No heterogeneity was measured by random effects ( I 2 =zero). Conclusion: Fundoscopic images obtained by using smartphones have substantial agreement with gold standards for clinical or photographic exams. Keywords: smartphones, fundoscopy, ophthalmoscopy