Application of Smartphone-Based Fundus Cameras and Telemedicine in the Brazilian Amazon Forest

Abstract

Smartphone-based fundus cameras and telemedicine are an opportunity for accessing ocular health inequalities in under-resourced areas. The objective of this study is to evaluate the prevalence of retinal findings in a community in the Amazon and propose strategies to enhance ocular health. A retrospective study was conducted in a riverside community. Retinal photos from the posterior pole and optic disc were captured using a portable fundus camera. All photos and data were analyzed remotely by a retina specialist. The final sample was 107 participants, aged 52 ± 17. Retinal findings were detected in 37.4% (95%CI 28.7–46.8) of the sample; the three main retinal findings were epithelial changes (10.3%, 95%CI 5.6–17.1), chorioretinal scars (8.4%, 95%CI 4.2–14.8), and dry age-related macular degeneration (7.5%, 95%CI 3.6–13.6). This study detected retinal alterations in a similar prevalence to that of other under-resourced areas. Telemedicine is an opportunity to address health inequities, especially in ophthalmology, through relatively low-cost portable devices, supporting clinical decisions in areas with low health access; however, maintaining assistance after implementation is a challenge. Enhancing medical education and training local non-specialized health professionals in risk assessment, device handling, and data base use is reasonable to ensure follow-up.