Clinical Ophthalmology (Feb 2020)
The Detection of Spontaneous Venous Pulsation with Smartphone Video Ophthalmoscopy
Abstract
Charlotte Laurent,1,2 Sheng Chiong Hong,3,4 Kirsten R Cheyne,2 Kelechi C Ogbuehi2 1Ophthalmology Department, Southern District Health Board, Dunedin, New Zealand; 2University of Otago, Dunedin, New Zealand; 3Ophthalmology Department, Mid Central District Health Board, Palmerston North, New Zealand; 4oDocs Eye Care Limited, Auckland, New ZealandCorrespondence: Charlotte LaurentOphthalmology Department, Dunedin Public Hospital, 201 Great King Street, Dunedin 9016, New ZealandTel +64 21 265 4347Email [email protected]: Spontaneous venous pulsation (SVP) has a high negative predictive value for raised intracranial pressure and is a useful sign when assessing patients with headache. The objective was to determine if smartphone-based video ophthalmoscopy can detect SVP.Patients and Methods: In total 233 patients and 291 eyes were recruited from the Dunedin Hospital eye clinic from July to November 2018. Patients were examined by a clinician and graded for SVP with a slit lamp and 78 Dioptre lens. Videos were taken with a smartphone ophthalmoscope and graded by two separate clinicians blinded to the slit lamp findings.Results: Only 272 eyes of 215 patients were included, as others failed in the inclusion criteria for overall video quality. Sensitivity was calculated as how likely the presence of SVP on video was indicative of the presence of SVP on slit lamp. Sensitivity was 84.77% for Observer 1, with 128 videos graded as positive for SVP on video ophthalmoscopy of the 151 identified as positive on slit lamp examination. Sensitivity was 76.82% for Observer 2 with 116 videos correctly identified. The false positive rate was calculated as the number of videos graded positive for SVP that had been graded as negative on slit lamp examination. This was 10.74% for observer 1 and 31.40% for observer 2.Conclusion: This study demonstrates that SVP is detected by video ophthalmoscopy. This may be a useful triage, telemedicine and referral tool to be used for patients with headache in a primary care setting.Keywords: technology, telemedicine, neurology, headache
