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, comprising 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.