摘要
<strong>Background:</strong> Glaucoma is a serious public health problem since it causes visual impairment impacting social, mental and physical health of an individual. Diagnosis and management of glaucoma continue to be a challenge due to few qualified personnel and high cost of the equipment. The use of portable Eye Examination Kit such as Smartphone and tablets can be used in glaucoma screening for taking high-resolution fundus photos for optic disc and visual field parameters, respectively. This study was conducted to evaluate the applicability of mobile electronic device to detect optic disc and visual field parameters for glaucoma in a resource limited setting. <strong>Objective:</strong> To evaluate the applicability of mobile electronic devices to detect optic disc and visual field parameters for glaucoma. <strong>Methodology:</strong> Across-sectional study was conducted at KCMC Eye department from October 2018 to June 2019. Study included 140 participants attending eye clinic of which 67 had glaucoma and 73 without glaucoma. Clinical and socio-demographic data were collected using a structured questionnaire and analysed using Stata 15. Glaucoma examination was made on the right eye and photo comparison made between those with and without glaucoma. PEEK Smartphone fundus photo examination was compared with the gold standard machine (Slit Lamp Biomicroscopy), Amsler grid chart installed on a tablet (Microsoft surface, internal storage 256 GB, 2013) and contrast sensitivity compared with Humphrey field analyser (i series, model 740117434, Carl Zeiss Meditec). <strong>Results:</strong> The kappa (k) agreement between Slit lump biomicroscopy fundus view image and PEEK Smartphone concerning the optic disc measurement was 0.92 with sensitivity and specificity of 90.32% (95% CI: 80.12 - 96.37) and 93.59% (95% CI: 85.67 - 97.89) with a p < 0.001 respectively. An agreement between Amsler grid and Humphrey Field Analyser was 0.67 with sensitivity of 33.33% (95% CI: 20.76 - 47.92) and specificity of 86.52% (95% CI: 77.63 - 92.83) with a p < 0.005. An agreement for contrast sensitivity and Humphrey Field Analyser was 0.51 with sensitivity of 48.91% (95% CI: 38.3 - 59.56) and specificity of 54.17% (95% CI: 39.17 - 68.63) and p value of 0.729. <strong>Conclusion:</strong> PEEK Smartphone fundus image specificity was almost in perfect agreement compared with Amsler grid and Contrast sensitivity. The PEEK Smartphone fundus view optic disc parameter for vertical cup to disc ratio has a potential to enhance detection of glaucoma and thus improve its management in resource-limited settings.
<strong>Background:</strong> Glaucoma is a serious public health problem since it causes visual impairment impacting social, mental and physical health of an individual. Diagnosis and management of glaucoma continue to be a challenge due to few qualified personnel and high cost of the equipment. The use of portable Eye Examination Kit such as Smartphone and tablets can be used in glaucoma screening for taking high-resolution fundus photos for optic disc and visual field parameters, respectively. This study was conducted to evaluate the applicability of mobile electronic device to detect optic disc and visual field parameters for glaucoma in a resource limited setting. <strong>Objective:</strong> To evaluate the applicability of mobile electronic devices to detect optic disc and visual field parameters for glaucoma. <strong>Methodology:</strong> Across-sectional study was conducted at KCMC Eye department from October 2018 to June 2019. Study included 140 participants attending eye clinic of which 67 had glaucoma and 73 without glaucoma. Clinical and socio-demographic data were collected using a structured questionnaire and analysed using Stata 15. Glaucoma examination was made on the right eye and photo comparison made between those with and without glaucoma. PEEK Smartphone fundus photo examination was compared with the gold standard machine (Slit Lamp Biomicroscopy), Amsler grid chart installed on a tablet (Microsoft surface, internal storage 256 GB, 2013) and contrast sensitivity compared with Humphrey field analyser (i series, model 740117434, Carl Zeiss Meditec). <strong>Results:</strong> The kappa (k) agreement between Slit lump biomicroscopy fundus view image and PEEK Smartphone concerning the optic disc measurement was 0.92 with sensitivity and specificity of 90.32% (95% CI: 80.12 - 96.37) and 93.59% (95% CI: 85.67 - 97.89) with a p < 0.001 respectively. An agreement between Amsler grid and Humphrey Field Analyser was 0.67 with sensitivity of 33.33% (95% CI: 20.76 - 47.92) and specificity of 86.52% (95% CI: 77.63 - 92.83) with a p < 0.005. An agreement for contrast sensitivity and Humphrey Field Analyser was 0.51 with sensitivity of 48.91% (95% CI: 38.3 - 59.56) and specificity of 54.17% (95% CI: 39.17 - 68.63) and p value of 0.729. <strong>Conclusion:</strong> PEEK Smartphone fundus image specificity was almost in perfect agreement compared with Amsler grid and Contrast sensitivity. The PEEK Smartphone fundus view optic disc parameter for vertical cup to disc ratio has a potential to enhance detection of glaucoma and thus improve its management in resource-limited settings.
作者
Francisco Alcides Mulobuana
Tolbert Sonda
Martin M. Rwabilimbo
William Makupa
Francisco Alcides Mulobuana;Tolbert Sonda;Martin M. Rwabilimbo;William Makupa(Kilimanjaro Christian Medical University College, Moshi, Tanzania;Kilimanjaro Clinical Research Institute, Moshi, Tanzania;Department of Epidemiology and Applied Biostatistics, Kilimanjaro Christian Medical College University, Moshi, Tanzania;Kilimanjaro Christian Medical Centre, Moshi, Tanzania)
