Smart Phone Based Retinal Imaging - A Practical Tool for Neurosurgeons

INTRODUCTION Effectiveness of papilledema in predicting raised intracranial pressure has been well documented over years. As medical fraternitys interest and reliance on direct ophthalmoscopy has waned over time, fundus photography has emerged as an alternative method of fundus examination. AIMS& OBJECTIVES In this study, our aim is to compare the efficacy of smart phone based retinal imaging with direct ophthalmoscopic examination in detecting papilledema in neurosurgical setting. MATERIALS& METHODSWe examined the fundus of 112 neurosurgery inpatients, with various neurosurgical conditions using smart phone based retinal imaging system and documented papilledema. We also obtained direct ophthalmoscopic evaluation by opthalmologists for these patients and results were compared with intraclass co-efficient agreement analysis RESULTS Of these 112 cases, using smart phone based retinal imaging system, papilledema was documented in 29 patients and primary optic atrophy in 5 patients. On direct ophthalmoscopic examination, papilledema was noted in 27 cases and primary optic atrophy in 5 cases. On comparison, results strongly agree, proving the efficacy of this system. CONCLUSION Smart phone based retinal imaging system is similar in efficacy to direct ophthalmoscopy for detection of papilledema. Constant improvement in technology and the potential for telemedicine will likely contribute to a widespread use of this technology in numerous specialities.