ESPEYB17 13. Global Health for the Paediatric Endocrinologist Diabetes (3 abstracts)
13.7. Smartphone-based, rapid, wide-field fundus photography for diagnosis of pediatric retinal diseases
Patel TP , Kim TN , Yu G , Dedania VS , Lieu P , Qian CX , Besirli CG , Demirci H , Margolis T , Fletcher DA & Paulus YM
To read the full abstract: Trans Vis Sci Tech. 2019; 8(3):29. doi: 10.1167/tvst.8.3.29
• This study investigates the feasibility of acquiring diagnostic quality fundus photographs in children using a child-friendly smartphone.• Photographs were acquired in 43 patients (mean age 6.7 years) with i.e. retinoblastoma, Coats’ disease, commotio retinae and optic nerve hypoplasia.• There was 96% agreement between image-based diagnosis and the treating clinician’s diagnosis. This device, which can acquire fundus photos in 2.3 minutes and is well-tolerated, brings the possibility of easily assessing retinal disease in children with diabetes.
This article shows us what the future could look like for children and adolescents with diabetes living in low resource-settings. The concept of ‘point of care testing’ (POC), where investigations are performed directly where the patient lives (instead of having the patient travel to a center where equipment is present) is developing fast. The authors developed a portable handheld smartphone-based retinal camera (like the one used in an i-phone). The device captures high-quality fundus images, stores them, and transmits them via the wireless communication system of the device for remote evaluation. This is a welcome innovation in countries where children with Type 1 diabetes experience early and severe diabetic complications and insufficient screening for these complications. It has many potential applications in pediatric endocrinology and diabetes. One of the most attractive is the use of POC testing for the neonatal screening for congenital hypothyroidism. In many low-resource settings, mothers deliver at home, time-sensitive shipment of samples is not feasible, central laboratories are non-existent, and recall of patients is difficult. POC testing could be performed by a visiting allied health professional who could then contact a specialist in case of positive results. It is hoped that in the coming few years, a variety of POC tests will be available for large scale use, bringing to children in developing countries the care they deserve.
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ESPE Yearbook of Paediatric Endocrinology
ISSN 1662-4009 (Online)
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