Robles Rafael, Patel Nikhil, Neag Emily, Mittal Ajay, Markatia Zahra, Ameli Kambiz, Lin Benjamin
Department of Ophthalmology, Virginia Commonwealth University School of Medicine, Richmond, VA, USA.
Bascom Palmer Eye Institute, University of Miami, Miami, FL, USA.
Clin Ophthalmol. 2023 Oct 6;17:2957-2965. doi: 10.2147/OPTH.S423845. eCollection 2023.
Recent advances in telemedicine have led to increased use of digital ophthalmoscopes (DO) in clinical settings. This review aims to assess commercially available DOs, including smartphone (SP), desktop, and handheld ophthalmoscopes, and evaluate their applications.
A literature review was performed by searching PubMed (pubmed.ncbi.nlm.nih.gov), Web of Science (webofknowledge.com), and Science Direct (sciencedirect.com). All English-language papers that resulted from the search terms "digital ophthalmoscope", "screening tool", "glaucoma screening", "diabetic retinopathy screening", "cataract screening", and "papilledema screening" were reviewed. Studies that contained randomized clinical trials with human participants between January 2010 and December 2020 were included. The Risk of Bias in Systematic Reviews (ROBIS) tool was used to assess the methodological quality of each included paper.
Of the 1307 studies identified, 35 met inclusion and exclusion criteria. The ROBIS tool determined that 29/35 studies (82.8%) had a low risk of bias, 3/35 (8.5%) had a moderate risk of bias, and 3/35 (8.5%) had a high risk of bias.
The continued adoption of DOs remains uncertain because of concerns about the image quality for non-mydriatic eyes and the confidence in data captured from the device. Likewise, there is a lack of guidelines for the use of DOs, which makes it difficult for providers to determine the best device for their practice and to ensure appropriate use. Even so, DOs continue to gain acceptance as technology and practice integration improve, especially in underserved areas with limited access to ophthalmologists.
远程医疗的最新进展已导致数字检眼镜（DO）在临床环境中的使用增加。本综述旨在评估市售的数字检眼镜，包括智能手机（SP）、台式和手持式检眼镜，并评估它们的应用。
通过检索PubMed（pubmed.ncbi.nlm.nih.gov）、科学网（webofknowledge.com）和Science Direct（sciencedirect.com）进行文献综述。对所有由搜索词“数字检眼镜”、“筛查工具”、“青光眼筛查”、“糖尿病视网膜病变筛查”、“白内障筛查”和“视乳头水肿筛查”得出的英文论文进行了综述。纳入了2010年1月至2020年12月期间包含人类参与者的随机临床试验的研究。使用系统评价中的偏倚风险（ROBIS）工具评估每篇纳入论文的方法学质量。
在识别出的1307项研究中，35项符合纳入和排除标准。ROBIS工具确定，29/35项研究（82.8%）偏倚风险低，3/35项（8.5%）偏倚风险中等，3/35项（8.5%）偏倚风险高。
由于对非散瞳眼睛的图像质量以及从该设备获取的数据的可信度存在担忧，数字检眼镜的持续采用情况仍不确定。同样，缺乏数字检眼镜的使用指南，这使得医疗服务提供者难以确定最适合其临床实践的设备并确保正确使用。即便如此，随着技术与实践整合的改善，数字检眼镜继续获得认可，尤其是在眼科医生可及性有限的服务不足地区。
