Clinical Ophthalmology (Oct 2023)
Diabetic Retinopathy Screening Using a Portable Retinal Camera in Vanuatu
Abstract
Juan Caceres,1,* Yibing Zhang,1,* Lawrence Boe,2 Yunshu Zhou,3 Cagri Besirli,3 Yannis M Paulus,3,4 Julie M Rosenthal3 1University of Michigan Medical School, University of Michigan, Ann Arbor, MI, USA; 2Penama Provincial Health, Godden Memorial Hospital, Ambae, Vanuatu; 3Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, MI, USA; 4Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, USA*These authors contributed equally to this workCorrespondence: Julie M Rosenthal; Yannis M Paulus, University of Michigan, Kellogg Eye Center, 1000 Wall Street, Ann Arbor, MI, 48105, USA, Email [email protected]; [email protected] and Objective: Proof-of-concept study to test the feasibility of using an all-in-one portable retinal camera for the screening of diabetic retinopathy in the Pacific Island of Vanuatu, which has a high rate of diabetes and its associated complications and a dearth of ophthalmologists.Study Design/Materials and methods: From February 10, 2020, through February 28, 2020, 49 patients with diabetes mellitus from three islands in Vanuatu were recruited to participate in the study. Demographics, basic health data and retinal photography were obtained. A non-mydriatic, handheld camera was used (Volk Pictor Plus).Results: Eleven participants (24%) had referral-warranted diabetic retinopathy. There was moderately high inter-rater reliability for our dependent variables: referral status (κ = 0.62, 95% CI 0.42– 0.83), retinopathy severity (κ = 0.76, 95% CI 0.55– 0.96), and clinically significant macular edema (κ = 0.50, 95% CI 0.25– 0.74).Conclusion: Our study confirms that portable handheld cameras can be used to obtain retinal images of sufficient quality for diabetic retinopathy screening even in resource limited environments like Vanuatu. Among this cohort, a relatively high (24%) prevalence of referral-warranted diabetic retinopathy was found in Vanuatu.Keywords: diabetic retinopathy, retinal screening, Vanuatu, portable retinal camera, Pictor
