Retinal Imaging Clinical Trial
Official title:
Quality and Diagnostic Utility of Mydriatic Fundus Plenoptic Photography: The Plenoptic Ophthalmoscopy Reliability Trial
1. Establish the quality of fundus images produced by plenoptic ophthalmoscopy using the
grading system proposed and utilized in the Fundus Photography versus Ophthalmoscopy
Trials Outcomes in the Emergency Department (FOTO-ED) Study.
2. Determine diagnostic utility of plenoptic ophthalmoscopy images by comparing masked
image reviewers' quality measurements and findings to images obtained with a
commercially available ocular fundus camera and documented exam findings
Visualization of the ocular fundus is considered an essential part of the physical
examination, as abnormalities of the optic nerve, retinal vessels, and macula can reveal
underlying systemic diseases and explain the etiology of visual complaints.
The Fundus Photography versus Ophthalmoscopy Trials Outcomes in the Emergency Department
(FOTO-ED) Study demonstrated that only 14% of patients with complaints and conditions in
which fundus examination is considered important had direct ophthalmoscopy performed by an ED
physician .Greater than 80% of previously unknown fundus findings relevant to ED patient
management were missed by ED physicians, but were identified by nonmydriatic digital fundus
photography. Several of these cases resulted in recall of a discharged patient back to the ED
for hospital admission once diagnostic fundus photos were reviewed.
In the search for an alternative to improve ease of use and fundus image quality, plenoptic
technology provides a promising option for portable fundus imaging. Plenoptic, or light
field, imaging has recently been introduced commercially with the release of the Lytro
Plenoptic Camera (Mountain View, CA, USA). Utilizing an array of microlenses, the Lytro
camera captures all available light in a scene from multiple vectors. By dividing up a scene
as a whole with many individual microlenses, images can be refocused in post processing after
acquisition, sharp focus can be attained in low light situations, and stereo images with
perspective shifting can be attained.
To date there have been no published quantitative descriptions of the quality and reliability
of plenoptic ophthalmoscopy using a commercially available, portable light field camera.
Initial work from a pilot study using animal and human eyes was published in 2016. The
purpose of the proposed prospective, cross sectional imaging study is to compare standard
mydriatic fundus photography to a second generation camera developed with a Lytro plenoptic
camera and customized light source, specifically analyzing diagnostic utility/sensitivity of
detecting retinal pathology and overall image quality. If the image quality outcomes of the
investigators proposed study are similar to those of the nonmydriatic fundus camera, the
implications for physicians and the potential applications to ophthalmology related
telemedicine are significant.
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