The field of teleophthalmology has been expanding in recent years due to the development and advancement of mobile fundus cameras. Many of these devices involve taking a video of the retina using a smartphone coupled with an attachable lens system. Despite recent advances, the videos that are obtained with these devices can sometimes be difficult to use for clinical purposes. This is because the videos often have a small field of view and can include blurry frames and blinks. In order to improve the ease at which these videos can be obtained and interpreted, a stabilization system and Android application for processing these videos was created. This Android application is intended to exclude unusable video frames, and stitch together the remaining frames into a single image. The effectiveness of this application is tested using videos obtained with the D-EYE device. These images are then compared to clinical images, and images obtained from the DEYE without the image stitching application. In this study, the image quality of the stitched images was found to be worse than that obtained from a clinical device.
Fundus cameras are the current clinical standard for capturing retinal images, which are used to diagnose a variety of sight-threatening conditions. Traditional fundus cameras are not easily transported, making them unsuitable for field use. In addition, traditional fundus cameras are expensive. Due to this, a variety of technologies have been developed such as the D-EYE Digital Ophthalmoscope (D-EYE Srl, Padova, Italy) which is compatible with various cellphone cameras. This paper reports on the comparison of the image quality of the Nidek RS-330 OCT Retina Scan Duo (Nidek, Tokyo, Japan) and the D-EYE paired with an iPhone 6 (Apple, Cupertino, USA). Twenty-one participants were enrolled in the study of whom 14 underwent nonmydriatic and mydriatic imaging with the D-EYE and the Nidek. Seven participants underwent nonmydriatic imaging with the D-EYE and the Nidek. The images were co-registered and cropped so that the region of interest was equal in both the D-EYE and Nidek images, as the D-EYE had a smaller field of view. Using the Nidek image as the reference, objective full-reference image quality analysis was performed. Metrics such as structural similarity index and peak signal noise ratio were obtained. It was found that the image quality of the D-EYE is limited by the attached iPhone camera, and is lower when compared to the Nidek. Quantification of the differences between the D-EYE and Nidek allows for targeted development of smartphone camera attachments that can help to bridge the current gap in image quality.
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