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Smartphone-basierte Fundusfotografie: Anwendungen und Adapter

Smartphone-based fundus imaging: applications and adapters

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Zusammenfassung

Hintergrund

Die Smartphone-basierte Fundusfotografie (SBF) stellt eine innovative und kostengünstige Möglichkeit zur Bildgebung des Augenhintergrundes dar. Seit den ersten Anwendungsberichten von vor über 10 Jahren wurde eine Vielzahl an Studien zu unterschiedlichen Adaptern und klinischen Anwendungen publiziert.

Ziel der Arbeit

Ziel dieser Arbeit ist es, einen Überblick zur Entwicklung der SBF, zu bisherigen Anwendungsbereichen und Adaptern zu geben.

Material und Methoden

Es wurde eine Literaturrecherche in den Datenbanken MEDLINE und Science Citation Index Expanded ohne zeitliche Einschränkung durchgeführt.

Ergebnisse

Elf Adapter wurden eingeschlossen und hinsichtlich beispielhaftem Bildmaterial, dargestellten Fundusbereich, Anschaffungskosten, Gewicht, Software, Anwendungsbereich, Smartphone-Kompatibilität und Zertifizierung verglichen. Bislang publizierte Anwendungsbereiche der SBF sind das Screening auf diabetische Retinopathie, Glaukom und Frühgeborenenretinopathie sowie ein Einsatz in der Notfallmedizin, Pädiatrie und medizinischen Lehre. Die Bildqualität konventioneller Geräte ist der SBF im Allgemeinen überlegen. Erste Ansätze zur automatischen Detektion diabetischer Retinopathie auf Smartphone-basierten Fundusbildern sind vielversprechend. Der Einsatz automatischer Bildverarbeitungsalgorithmen ermöglicht die Erstellung von Weitwinkelaufnahmen.

Diskussion

Die SBF ist eine vielseitig einsetzbare, mobile und kostengünstige Alternative zu konventionellen Geräten für die Fundusfotografie. Darüber hinaus eignet sie sich im Rahmen telemedizinischer Ansätze zur Delegation einfacher ophthalmologischer Untersuchungen an Hilfspersonal und könnte zur Vereinfachung von Befunddokumentation, Verbesserung der Lehre und v. a. in Ländern mit niedrigem/mittlerem Einkommen zur Verbesserung der augenärztlichen Versorgung beitragen.

Abstract

Background

Smartphone-based fundus imaging (SBFI) is an innovative and low-cost alternative for color fundus photography. Since the first reports on this topic more than 10 years ago a large number of studies on different adapters and clinical applications have been published.

Objective

The aim of this review article is to provide an overview on the development of SBFI and adapters and clinical applications published so far.

Material and methods

A literature search was performed using the MEDLINE and Science Citation Index Expanded databases without time restrictions.

Results

Overall, 11 adapters were included and compared in terms of exemplary image material, field of view, acquisition costs, weight, software, application range, smartphone compatibility and certification. Previously published SBFI applications are screening for diabetic retinopathy, glaucoma and retinopathy of prematurity as well as the application in emergency medicine, pediatrics and medical education/teaching. Image quality of conventional retinal cameras is in general superior to SBFI. First approaches on automatic detection of diabetic retinopathy through SBFI are promising and the use of automatic image processing algorithms enables the generation of wide-field image montages.

Conclusion

SBFI is a versatile, mobile, low-cost alternative to conventional equipment for color fundus photography. In addition, it facilitates the delegation of ophthalmological examinations to assistance personnel in telemedical settings, could simplify retinal documentation, improve teaching, and improve ophthalmological care, particularly in countries with low and middle incomes.

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Förderung

Finanzielle Unterstützung wurde von der Else Kröner Fresenius Stiftung/German Scholars Organization (Förder-Nr. EKFS/GSO 16 an RPF) und von dem BONFOR GEROK Program, Medizinische Fakultät, Universität Bonn (Förder-Nr. O‑137.0028 an MWMW) zur Verfügung gestellt.

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Authors and Affiliations

  1. Klinik für Augenheilkunde, Universitätsklinikum Bonn, Ernst-Abbe-Str. 2, 53127, Bonn, Deutschland

    Linus G. Jansen, Frank G. Holz, Robert P. Finger & Maximilian W. M. Wintergerst

  2. Institut für Informatik II, Universität Bonn, Friedrich-Hirzebruch-Allee 5, 53115, Bonn, Deutschland

    Thomas Schultz

  3. Bonn-Aachen International Center for Information Technology (B-IT), Universität Bonn, Friedrich-Hirzebruch-Allee 5, 53115, Bonn, Deutschland

    Thomas Schultz

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  1. Linus G. Jansen
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Correspondence to Maximilian W. M. Wintergerst.

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Interessenkonflikt

L.G. Jansen: finanzielle Förderung: Deutsche Ophthalmologische Gesellschaft (DOG); Reisekostenförderung: Gesellschaft für internationale Zusammenarbeit (GIZ). F.G. Holz: finanzielle Förderung: Acucela, Allergan, Apellis, Bayer, Bioeq/Formycon, Roche/Genentech, Geucer, Heidelberg Engineering, iVericBio, Kanghong, Novartis, Zeiss; Beratertätigkeit: Boehringer-Ingelheim, Grayburg Vision, Lin BioScience, Pixum Vision, Stealth BioTherapeutics, Aerie, Oxuxrion. M.W.M. Wintergerst: finanzielle Förderung: BONFOR GEROK Program, Faculty of Medicine, University of Bonn (Förder-Nr. O‑137.0028), Else Kröner-Fresenius Stiftung, Bundesministerium für Wirtschaftliche Zusammenarbeit und Entwicklung (BMZ), CenterVue SpA, Berlin-Chemie AG, Deutsche Ophthalmologische Gesellschaft (DOG), Heine Optotechnik GmbH; Beratertätigkeit: Heine Optotechnik GmbH; Honorare für Referententätigkeit: ASKIN & CO GmbH, Heine Optotechnik GmbH; Reisekostenförderung: ASKIN & CO GmbH, Berlin-Chemie AG, DigiSight Technologies, Heine Optotechnik GmbH, European Society of Retina Specialists (EURETINA), Deutscher Akademischer Austauschdienst (DAAD), Association for Research in Vision and Ophthalmology (ARVO); kostenlose zur Verfügungstellung von Material/Dienstleistungen: Heidelberg Engineering, Optos, Carl Zeiss Meditec, CenterVue SpA, D‑Eye Srl, Heine Optotechnik GmbH, Eyenuk, Inc. T. Schultz und R.P. Finger geben an, dass kein Interessenkonflikt besteht.

Für diesen Beitrag wurden von den Autoren keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.

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Jansen, L.G., Schultz, T., Holz, F.G. et al. Smartphone-basierte Fundusfotografie: Anwendungen und Adapter. Ophthalmologe 119, 112–126 (2022). https://doi.org/10.1007/s00347-021-01536-9

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