Selfie fundus imaging may increase accessibility to diabetic retinopathy screening. Photo: Julie Torbit, OD, Anna Kathryn Bedwell, OD, Daniel Bollier, OD, and Brad Sutton, OD.
Selfie fundus imaging may increase accessibility to diabetic retinopathy screening. Photo: Julie Torbit, OD, Anna Kathryn Bedwell, OD, Daniel Bollier, OD, and Brad Sutton, OD. Click image to enlarge.

A large part of the diabetic population doesn’t undergo annual diabetic retinopathy screening partly because of some of the barriers it presents, such as lack of access and affordability. Add the COVID-19 pandemic to the mix and it’s made problems even worse, but selfie fundus imaging (SFI), an innovative approach where patients take photos of the retina themselves, has the potential to make things easier for both patients and physicians alike.

Looking into the efficacy of SFI, researchers captured retinal images using three different approaches on 60 participants—SFI, smartphone-based photographs captured by a trained technician and photographs taken on a digital fundus camera. The authors believe this is the first study investigating SFI’s role in screening diabetic patients for retinopathy.

Ninety of the selfie images obtained by the study participants were of good quality. Though there were challenges upfront, about half of the patients were able to accomplish the task and the remaining could do so with minimal assistance. Once the patients became acquainted with the procedure and the device, the majority were able to capture usable images within 30 to 45 seconds. The quality of SFI was also highly comparable to the photographs taken by a trained specialist on the same device.

SFI can overcome the barriers of availability, accessibility and affordability, and if individuals don’t have access to smartphones, SFI may be made available at other public facilities like post offices and banks, for example.

“With greater penetration, advances and availability of mobile technology, including camera resolution and specific health-related apps, we believe that SFI would positively impact the success of diabetic retinopathy screening programs, both in normal circumstances as well as situations like the ongoing COVID-19 infection,” the authors concluded.

Kuman S, Venkatesh P, Tandon N, et al. Selfie fundus imaging for diabetic retinopathy screening. Eye (Lond). October 12, 2021. [Epub ahead of print].