COECSA, Journal, Ophthalmology
Validity of smartphone fundus photography in diagnosing diabetic retinopathy at Mbarara Regional Referral Hospital, South Western, Uganda



How to Cite

A, B.-S. ., S, R. ., & J, O. . (2020). Validity of smartphone fundus photography in diagnosing diabetic retinopathy at Mbarara Regional Referral Hospital, South Western, Uganda: Validity of smartphone fundus photography in diagnosing diabetic retinopathy at Mbarara Regional Referral Hospital, South Western, Uganda. The Journal of Ophthalmology of Eastern, Central and Southern Africa, 21(Issue 2). Retrieved from


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.



Mathenge W, Bastawrous A, Peto T, Leung I, Yorston

D, Foster A, et al. Prevalence and correlates of

diabetic retinopathy in a population-based survey of

older people in Nakuru, Kenya. Ophthal Epidemiol.

; 21(3):169-77.

Maurya P. Diabetic retinopathy: My brief synopsis.

indian J Clin Experim Ophthalmol. 2015; 1(4):189-190.

WHO. Prevention of blindness from diabetes

mellitus. Geneva: 2005 November, 2005. Report No.

Association AD. Standards of medical care

in diabetes - 2015. J Clin Applied Res Educ.


Allyn W. iExaminer Eye Imaging for your iPhone’.

Rajalakshmi R, Arulmalar S, Usha M, Prathiba V,

Kareemuddin KS, Anjana RM, et al. Validation

of smartphone based retinal photography for

diabetic retinopathy screening. PloS One. 2015;


Seba EG, Twinamasiko AWT, Bwonya BD. Factors

influencing attendance and patterns of visual

impairment in patients with diabetes at Mbarara

Regional Referral Hospital and Ruharo Eye Centre.

J Ophthalmol East Central South Africa. 2015;


Omolase CO, Adekanle O, Owoeye JF, Omolase

BO. Diabetic retinopathy in a Nigerian community.

Singapore Med J. 2010; 51(1):56-59.

Journal of Ophthalmology of Eastern Central and Southern Africa December 2017

Maboreke NP, Ndhlovu CE. Prevalence of diabetic

retinopathy at Parirenyatwa Hospital: University of

Zimbabwe; 2015.

Bobb-Semple A, Arunga S, Ruvuma S. Clinical

characteristics and management of patients with

diabetic retinopathy at Mbarara University Referral

Hospital Eye Centre and Ruharo Eye Centre from

-2014: A retrospective clinical audit. 2014.

Akpalu J, Gichuhi S, Ilako DR. Magnitude, pattern

and level of awareness of diabetic retinopathy

at Korle-Bu Teaching Hospital Accra-Ghana:

University of Nairobi; 2011.

Russo A, Morescalchi F, Costagliola C, Delcassi L,

Semeraro F. Comparison of smartphone ophthalmoscopy

with slit-lamp biomicroscopy for grading diabetic

retinopathy. Amer J Ophthalmol. 2015; 159(2):360-4 e1.

Ryan ME, Rajalakshmi R, Prathiba V, Anjana

RM, Ranjani H, Narayan KM, et al. Comparison

among methods of retinopathy assessment

(CAMRA) study: Smartphone, nonmydriatic, and

mydriatic photography. Ophthalmology. 2015;


Toy BC, Myung DJ, He L, Pan CK, Chang RT,

Polkinhorne A, et al. Smartphone-based dilated

fundus photography and near visual acuity testing

as inexpensive screening tools to detect referral

warranted diabetic eye disease. Retina. 2016;



Download data is not yet available.