A pilot study for smartphone photography to assess bleb morphology and vasculature post-trabeculectomy
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ORIGINAL PAPER
A pilot study for smartphone photography to assess bleb morphology and vasculature post-trabeculectomy Gagan Kalra . Parul Ichhpujani . Sahil Thakur . Rohan Bir Singh . Urvashi Sharma . Suresh Kumar
Received: 24 May 2020 / Accepted: 1 October 2020 Springer Nature B.V. 2020
Abstract Purpose The current grading systems used for bleb morphology assessment in patients post-trabeculectomy are based on standardized slit-lamp photographs and anterior segment imaging devices. The lack of availability of these expensive and non-portable devices in resource-deficient settings is a significant deterrent in their widespread utilization for proper post-operative management. The rapidly evolving utilization of smartphone photography has significantly benefited diagnostics of posterior segment disorders and is now being increasingly utilized for monitoring anterior segment pathologies as well as post-surgical course. In this study, we study a novel use of smartphones for bleb photography for assessing Electronic supplementary material The online version of this article (https://doi.org/10.1007/s10792-020-01598-9) contains supplementary material, which is available to authorized users. G. Kalra P. Ichhpujani (&) U. Sharma S. Kumar Department of Ophthalmology, Government Medical College and Hospital, Chandigarh, India e-mail: [email protected] S. Thakur Department of Ocular Epidemiology, Singapore Eye Research Institute, Singapore, Singapore R. B. Singh Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
the morphological characteristics as vascularity and microcysts. Methods In this pilot, observational study, we compared the trabeculectomy bleb images of five subjects, obtained by iPhone X (dual lens) and iPhone 6S (single lens). We captured two image sets with both smartphones first with a focussed torchlight and then with a built-in flash video light. Results The images resulting from the newer iPhone X were substantially superior than those from iPhone 6S. For the 12-megapixel dual-camera set-up on the iPhone X, the 1 9 lens resulted in better images than the 2 9 lens with contrast and overall clarity of the area of interest. While the macro-lens attachment had promising results at 1 9 zoom, there is no added advantage of the macro-lens attachment as it resulted in considerable loss of image quality at twice the zoom. Using a 20 D lens helped attain higher magnification and better framing as it reduced the focussing distance needed to get sharp images. The images obtained from both smartphones were of higher quality when illuminated from an external source when compared to the native iPhone flash due to even exposure and fewer autofocus artefacts. Conclusion Analyses of all image sets showed that the current generation in-built camera app on IOS and newer iPhone camera optics resulted in high-quality images of the ocular surface with high magnification without any loss in clarity.
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