Objective: To evaluate the effectiveness of text messaging in improving adherence to occlusion therapy for amblyopia. The secondary objective was to correlate the responses given in a self-reporting questionnaire with treatment outcome (improvement in visual acuity).Methods: This is a prospective, randomized, blinded clinical trial. The patients' parents or legal guardians in the intervention group received text messages reminding them of the importance of patching. The control group received no text messages. At final evaluation, after a period of three to six months, the patients' parents or legal guardians answered a self-reporting questionnaire to evaluate adherence to treatment. Results:The study included 34 patients with an average age of 5.35 years, 20 in the intervention group and 14 in the control group. According to the results of the self-reporting questionnaire, 50% of the study population was considered as having low adherence to treatment, 29% as having medium adherence, and 21% as having good adherence. There was no significant difference between trial groups. The comparison between an improvement in visual acuity and the mean value obtained in the self-reporting questionnaire showed a significant association between this improvement and adherence to treatment (p=0.03). Conclusion:The present study did not find a correlation between text messaging and an improvement in adherence to occlusion therapy, as shown by previous studies for different treatments. A statistically significant association was identified between an improvement in visual acuity and a good therapeutic adherence, as measured by the self-reporting questionnaire. This finding allows us to recommend using a self-reporting questionnaire as a simple method to measure adherence to treatment and help decisions about therapeutic strategies to be adopted in the patient's continuing treatment.
The number of people with diabetes mellitus (DM) has risen from 108 million in 1980 to 422 million in 2014. Diabetic retinopathy (DR) is one of the most common causes of blindness in the developed world. A pooled analysis of data from between 1980-2008 estimates that 93 million people around the world have DR. In this paper, we present a computer-aided automated image analysis system capable of handling images generated in real-life screening program. In this study, we analyzed 2932 color fundus images taken from 733 patients with DM, of which 454 (15%) images showed signs of DR validated by human graders. The system analyzed all images by detecting
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