Efficacy of cost-effective, portable nonmydriatic fundus camera, manufactured in India, to detect retinal pathology in comparison with regular mydriatic fundus camera

Abstract

Background: Diabetic retinopathy is a major public health problem and causes a huge economic burden. Therefore, a cost-effective screening tool for its detection is warranted. This study analyzes the efficacy of a low-cost, portable, Indian-made, nonmydriatic fundus camera as a tool for mass screening. Objective: To assess the potential to detect retinal pathology by cost-effective, portable, nonmydriatic fundus camera compared with regular dilated fundus imaging system and to assess its utility as a screening tool. Materials and Methods: A cross-sectional study was carried out at Kasturba Medical College, Manipal, Karnataka, India. The study period was from February 2011 to April 2011. Retinal images (n = 451) were captured using nonmydriatic fundus/test camera and regular mydriatic fundus camera. Diagnosis of normal fundus (n = 167), diabetic retinopathy (n = 180), and abnormal cup:disc ratio (n = 104) was made by a senior ophthalmologist, and then, the retinal images were classified by two ophthalmologist who were blinded to each other’s findings. SPSS, version 15, and kappa coefficient were used for statistical analysis. Results: Nonmydriatic camera was noted to have a sensitivity of 88.3% (159/180 images) and 100% in detecting diabetic retinopathy and abnormal cup-to-disc ratio, respectively. Diagnostic accuracy of 91.1% was noted in the detection of diabetic retinopathy with nonmydriatic camera in comparison with the regular camera, with kappa coefficient being 0.82 and p < 0.001. Conclusion: Nonmydriatic fundus camera being cost-effective, quick, convenient, and portable, with high sensitivity and diagnostic accuracy is a useful tool for mass screening of diabetic retinopathy and glaucoma.