Smartphone-based fundus imaging: applications and adapters

Background Smartphone-based fundus imaging (SBFI) is an innovative and low-cost alternative for color fundus photography. Since the first reports on this topic more than 10 years ago a large number of studies on different adapters and clinical applications have been published. Objective The aim of this review article is to provide an overview on the development of SBFI and adapters and clinical applications published so far. Material and methods A literature search was performed using the MEDLINE and Science Citation Index Expanded databases without time restrictions. Results Overall, 11 adapters were included and compared in terms of exemplary image material, field of view, acquisition costs, weight, software, application range, smartphone compatibility and certification. Previously published SBFI applications are screening for diabetic retinopathy, glaucoma and retinopathy of prematurity as well as the application in emergency medicine, pediatrics and medical education/teaching. Image quality of conventional retinal cameras is in general superior to SBFI. First approaches on automatic detection of diabetic retinopathy through SBFI are promising and the use of automatic image processing algorithms enables the generation of wide-field image montages. Conclusion SBFI is a versatile, mobile, low-cost alternative to conventional equipment for color fundus photography. In addition, it facilitates the delegation of ophthalmological examinations to assistance personnel in telemedical settings, could simplify retinal documentation, improve teaching, and improve ophthalmological care, particularly in countries with low and middle incomes.