Article Category:
Research Article

Evaluation of the Performance of a 3D-Printed Smartphone-Based Retinal Imaging Device as a Screening Tool for Retinal Pathology in Mozambique

Rosauro Varo ISGlobal, Hospital Clínic—Universitat de Barcelona, Barcelona, Spain;
Centro de Investigação em Saúde de Manhiça, Maputo, Mozambique;

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María Postigo SpotLab, Madrid, Spain;

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Rubao Bila Centro de Investigação em Saúde de Manhiça, Maputo, Mozambique;

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Elena Dacal SpotLab, Madrid, Spain;

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Hélio Chiconela Centro de Investigação em Saúde de Manhiça, Maputo, Mozambique;

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Jaime García-Villena SpotLab, Madrid, Spain;

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Daniel Cuadrado SpotLab, Madrid, Spain;

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Alexander Vladimirov SpotLab, Madrid, Spain;

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Nuria Díez SpotLab, Madrid, Spain;

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Ramón Vallés-López SpotLab, Madrid, Spain;

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Antonio Sitoe Centro de Investigação em Saúde de Manhiça, Maputo, Mozambique;

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Pio Vitorino Centro de Investigação em Saúde de Manhiça, Maputo, Mozambique;

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Campos Mucasse Centro de Investigação em Saúde de Manhiça, Maputo, Mozambique;

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Laura Beltran-Agullo Institut Català de Retina, Barcelona, Spain;

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Olivia Pujol Institut Català de Retina, Barcelona, Spain;
Hospital Vall d´Hebron, Barcelona, Spain;

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Virginia García Institut Català de Retina, Barcelona, Spain;

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Mariamo Abdala Departamento de Oftalmologia, Hospital Central de Maputo, Maputo, Mozambique;
Faculdade de Medicina, Universidade Eduardo Mondlane, Maputo, Mozambique;

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Lucía Sallé Biomedical Image Technologies Group, Departamento de Ingeniería Electrónica, Escuela Técnica Superior de Ingenieros Telecomunicación, Universidad Politécnica de Madrid, Madrid, Spain;

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Alfonso Anton Institut Català de Retina, Barcelona, Spain;
CIBER de Bioingeniería, Biomateriales y Nanomedicina, Instituto de Salud Carlos III, Madrid, Spain;

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Andrés Santos Biomedical Image Technologies Group, Departamento de Ingeniería Electrónica, Escuela Técnica Superior de Ingenieros Telecomunicación, Universidad Politécnica de Madrid, Madrid, Spain;
CIBER de Bioingeniería, Biomateriales y Nanomedicina, Instituto de Salud Carlos III, Madrid, Spain;

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María J. Ledesma-Carbayo Biomedical Image Technologies Group, Departamento de Ingeniería Electrónica, Escuela Técnica Superior de Ingenieros Telecomunicación, Universidad Politécnica de Madrid, Madrid, Spain;
CIBER de Bioingeniería, Biomateriales y Nanomedicina, Instituto de Salud Carlos III, Madrid, Spain;

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Miguel Luengo-Oroz SpotLab, Madrid, Spain;

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Quique Bassat ISGlobal, Hospital Clínic—Universitat de Barcelona, Barcelona, Spain;
Centro de Investigação em Saúde de Manhiça, Maputo, Mozambique;
Institut Català de Recerca i Estudis Avançats, Barcelona, Spain;
Pediatrics Department, Hospital Sant Joan de Déu, Universitat de Barcelona, Esplugues, Barcelona, Spain;
CIBER de Epidemiología y Salud Pública, Instituto de Salud Carlos III, Madrid, Spain

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DOI:
https://doi.org/10.4269/ajtmh.23-0378
Volume/Issue:
Volume 109: Issue 5
Page(s):
1192–1198
Restricted access
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ABSTRACT.

Low-income countries carry approximately 90% of the global burden of visual impairment, and up to 80% of this could be prevented or cured. However, there are only a few studies on the prevalence of retinal disease in these countries. Easier access to retinal information would allow differential diagnosis and promote strategies to improve eye health, which are currently scarce. This pilot study aims to evaluate the functionality and usability of a tele-retinography system for the detection of retinal pathology, based on a low-cost portable retinal scanner, manufactured with 3D printing and controlled by a mobile phone with an application designed ad hoc. The study was conducted at the Manhiça Rural Hospital in Mozambique. General practitioners, with no specific knowledge of ophthalmology or previous use of retinography, performed digital retinographies on 104 hospitalized patients. The retinographies were acquired in video format, uploaded to a web platform, and reviewed centrally by two ophthalmologists, analyzing the image quality and the presence of retinal lesions. In our sample there was a high proportion of exudates and hemorrhages—8% and 4%, respectively. In addition, the presence of lesions was studied in patients with known underlying risk factors for retinal disease, such as HIV, diabetes, and/or hypertension. Our tele-retinography system based on a smartphone coupled with a simple and low-cost 3D printed device is easy to use by healthcare personnel without specialized ophthalmological knowledge and could be applied for the screening and initial diagnosis of retinal pathology.

Author Notes

Disclosure: The study protocol, which followed the Declaration of Helsinki Ethical Principles, was reviewed and approved by the Mozambican National Bioethics Committee (CNBS) (Ref. 149/CNBS/17) and the Clinical Research Ethics Committee of the Centro de Investigação em Saúde de Manhiça (CISM; Ref. CIBS-CISM/135/2016). All participants were given detailed oral and written information about the study and signed a written informed consent document before participation in any study activity.

Authors’ addresses: Rosauro Varo, ISGlobal, Hospital Clínic—Universitat de Barcelona, Barcelona, Spain, and Centro de Investigação em Saúde de Manhiça, Maputo, Mozambique, E-mail: rosauro.varo@isglobal.org. María Postigo, Elena Dacal, Jaime García-Villena, Daniel Cuadrado, Alexander Vladimirov, Nuria Díez, Ramón Vallés-López, and Miguel Luengo-Oroz, SpotLab, Madrid, Spain, E-mails: maria@spotlab.org, elena@spotlab.org, jaime@spotlab.org, danielcuadrado@spotlab.org, alex@spotlab.org, nuria@spotlab.org, ramon@spotlab.org, and miguel@spotlab.org. Rubao Bila, Hélio Chiconela, Antonio Sitoe, Pio Vitorino, and Campos Mucasse, Centro de Investigação em Saúde de Manhiça, Maputo, Mozambique, E-mails: rubaobila92@gmail.com, hm.chiconela@gmail.com, antonio.sitoe@manhica.net, pio.vitorino@manhica.net, and campos.mucasse@manhica.net. Laura Beltran-Agullo and Virginia García, Institut Català de Retina, Barcelona, Spain, E-mails: laurabeltragullo@gmail.com and vgarcia@icrcat.com. Olivia Pujol, Institut Català de Retina, Barcelona, Spain, and Hospital Vall d´Hebron, Barcelona, Spain, E-mail: olpuca@hotmail.com. Mariamo Abdala, Departamento de Oftalmologia, Hospital Central de Maputo, Maputo, Mozambique, and Faculdade de Medicina, Universidade Eduardo Mondlane, Maputo, Mozambique, E-mail: mariamoabdala@yahoo.com.br. Lucía Sallé, Biomedical Image Technologies Group, Departamento de Ingeniería Electrónica, Escuela Técnica Superior de Ingenieros Telecomunicación, Universidad Politécnica de Madrid, Madrid, Spain, E-mail: lucia@spotlab.org. Alfonso Anton, Institut Català de Retina, Barcelona, Spain, and CIBER de Bioingeniería, Biomateriales y Nanomedicina, Instituto de Salud Carlos III, Madrid, Spain, E-mail: aanton@uic.es. Andrés Santos and María J. Ledesma-Carbayo, Biomedical Image Technologies Group, Departamento de Ingeniería Electrónica, Escuela Técnica Superior de Ingenieros Telecomunicación, Universidad Politécnica de Madrid, Madrid, Spain, and CIBER de Bioingeniería, Biomateriales y Nanomedicina, Instituto de Salud Carlos III, Madrid, Spain, E-mails: andres@die.upm.es and mj.ledesma@upm.es. Quique Bassat, ISGlobal, ISGlobal, Hospital Clínic—Universitat de Barcelona, Barcelona, Spain, Centro de Investigação em Saúde de Manhiça, Maputo, Mozambique, Institut Català de Recerca i Estudis Avançats, Barcelona, Spain, Pediatrics Department, Hospital Sant Joan de Déu, Universitat de Barcelona, Esplugues, Barcelona, Spain, and CIBER de Epidemiología y Salud Pública, Instituto de Salud Carlos III, Madrid, Spain, E-mail: quique.bassat@isglobal.org.

Address correspondence to Quique Bassat, Centro de Investigação em Saúde de Manhiça, CISM, Rua 12, Vila da Manhiça, CP1929, Maputo, Mozambique, E-mail: quique.bassat@isglobal.es
Copyright:
© American Society of Tropical Medicine and Hygiene 2023
Received:
20 Jun 2023
|
Accepted:
07 Aug 2023
|
Published Online:
09 Oct 2023
Cover The American Journal of Tropical Medicine and Hygiene
The American Journal of Tropical Medicine and Hygiene
Print ISSN:
0002-9637
Online ISSN:
1476-1645
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