Abstract
Objective: To determine the sensitivity and specificity of smartphone funduscopy in diagnosing and staging
Diabetic Retinopathy (DR) in diabetics attending Mbarara Regional Referral Hospital (MRRH).
Design: Analytical, hospital based cross sectional study.
Setting: Diabetic clinic of MRRH, Mbarara.
Participants: Diabetic patients (n=207) ≥ 18 years were recruited from the diabetic clinic of MRRH.
Measures: Sensitivity and specificity of smartphone photographs was analysed using indirect ophthalmoscopy
as the gold standard.
Results: Sensitivity of smartphone in diagnosing DR was 70% and specificity 94%. The sensitivity and specificity
of the smartphone in grading proliferative diabetic retinopathy was 100% and 99.4%. For macular edema,
sensitivity was 38.5% and specificity 97.9%. Kappa agreement was 0.86 in diagnosing DR and 0.84 in grading
diabetic retinopathy. The prevalence of DR was 13.5%.
Conclusion: The study found that the sensitivity of the smartphone in diagnosing diabetic retinopathy was only
70%. Hence we do not recommend this device to be used in the screening of patients with diabetes.
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