Accuracy of Detection and Grading of Diabetic Retinopathy and Diabetic Macular Edema Using Teleretinal Screening

Date, Rishabh C.; Shen, Kevin L.; Shah, Bhavik; Sigalos-Rivera, Mara A.; Chu, Yvonne I.; Weng, Christina Y.

doi:10.1016/j.oret.2018.12.003

Cited by 24 publications

(23 citation statements)

References 33 publications

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“…Patient adherence with tele-OCT management recommendations was 76.4%, which is better than or comparable with the follow-up rates after 1 year for non-OCT teleretinal screening programs in other studies, which range from 51.0% to 75.5%. [13][14][15] Not surprisingly, our study found that patients were more likely to follow-up when they experienced loss of central vision or when an intravitreal injection was recommended. We speculate that having activities of daily living affected motivated patients to adhere to followup eye care and the need for intravitreal injections was associated with greater disease severity, also leading to patient adherence.…”

Section: Discussionmentioning

confidence: 62%

Implementation of Teleretinal Screening Using Optical Coherence Tomography in the Veterans Health Administration

Ashrafzadeh

Gundlach

Tsui

2021

Telemedicine and e-Health

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Background: The Veterans Health Administration (VHA) has an existing teleretinal screening program that uses nonmydriatic fundus photography to screen for diabetic retinopathy in primary care clinics. Concurrently, optical coherence tomography (OCT) has become a routine screening modality in eye clinics for the diagnosis and management of retinal diseases. Introduction: This study aimed to evaluate the first year of a pilot tele-OCT program that used existing resources within the VHA. Without the tele-OCT program, all patients would have been referred to retina clinic for an in-person evaluation. Materials and Methods: This is a retrospective chart review study of patients evaluated by a retina specialist through asynchronous tele-OCT evaluation in 2019. Electronic medical records were used to assess patients' demographic and clinical characteristics, tele-OCT consult results, and patient adherence to tele-OCT follow-up plans. Results: There were 158 tele-OCT consults originating from optometry and nonretinal ophthalmology clinics in 2019. After tele-OCT evaluation, 113 (71.5%) patients were recommended to be monitored in their originating eye clinic, 27 (17.1%) were referred to intravitreal injection clinic, and 12 (7.6%) were referred to retina clinic for in-person evaluation. Patient adherence to tele-OCT follow-up plans was 76.4%. Patients with decreased central vision (p = 0.007) and patients referred to intravitreal injection clinic (p = 0.043) were most adherent to follow-up.Discussion: The tele-OCT program reduced unnecessary inperson clinic visits and enabled more retina clinic availability. Follow-up adherence was greatest among symptomatic patients and those requiring treatment. Conclusions: Tele-OCT can extend tertiary care resources and improve patient care in a large multidisciplinary eye care practice.

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Section: Discussionmentioning

confidence: 62%

Implementation of Teleretinal Screening Using Optical Coherence Tomography in the Veterans Health Administration

Ashrafzadeh

Gundlach

Tsui

2021

Telemedicine and e-Health

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“…The data collected in medical centers from diabetic patients during camera-based fundus examinations are sent for diabetic retinopathy detection to experts including ophthalmologists or retinal specialists [ 13 , 16 , 18 , 20 , 21 , 23 , 24 , 26 – 29 , 32 , 33 , 35 , 42 – 45 , 47 – 52 , 54 , 56 , 64 , 67 – 75 , 79 , 81 – 83 ], certified technicians and nurses; in more complicated cases, the data are reevaluated by retinal specialists [ 12 , 15 , 20 , 31 , 41 , 44 , 59 , 63 , 66 , 78 , 102 ].…”

Section: Resultsmentioning

confidence: 99%

“…It was possible to transfer the data via web and receive immediate online diagnosis [ 25 , 29 ]. There was also a special teleretinal screening software platform used [ 16 , 22 , 26 , 27 , 29 , 30 , 35 , 37 , 44 , 47 , 51 , 54 , 56 , 59 , 65 – 67 , 69 , 70 , 72 , 75 , 81 , 97 ] or, alternatively, access to all information could be obtained through a special account on a medical platform.…”

Section: Resultsmentioning

confidence: 99%

“…A serious problem related to telescreening was a low percentage of follow-up of vision-threatening diabetic retinopathy (VTDR) due to social and educational factors such as low education level, limited elderly mobility, transport difficulties, loneliness, depression, financial problems, distrust of the recommended hospital, making the referral appointment, fear of examination and treatment, no response to previous treatment and no sensation of being ill [ 28 , 29 , 56 , 116 – 118 ]. In an attempt to reduce the negative effects of poor education, telescreening was combined with diabetes education, which improved diabetes control [ 24 , 26 , 39 ].…”

Section: Resultsmentioning

confidence: 99%

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The Role of Telemedicine, In-Home Testing and Artificial Intelligence to Alleviate an Increasingly Burdened Healthcare System: Diabetic Retinopathy

2021

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“…In a retrospective observational study consisting of 1776 patients, a single-field 45°nonmydriatic color fundus photograph was remotely examined by a specialist and then compared with an in-person dilated fundus examination. The study demonstrated a high level of accuracy in detecting and classifying DR, although DME detection was found to a lesser degree [18]. A cross-sectional hospital-based study of 978 diabetic patients in Riyadh, Saudi Arabia, demonstrated that remote non-mydriatic funduscopic screening photography could be useful for the initial detection of DR among diabetic patients [19].…”

Section: Diabetic Retinopathymentioning

confidence: 87%

Telemedicine in ophthalmology in view of the emerging COVID-19 outbreak

Sommer

Blumenthal

2020

Graefes Arch Clin Exp Ophthalmol

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Purpose Technological advances in recent years have resulted in the development and implementation of various modalities and techniques enabling medical professionals to remotely diagnose and treat numerous medical conditions in diverse medical fields, including ophthalmology. Patients who require prolonged isolation until recovery, such as those who suffer from COVID-19, present multiple therapeutic dilemmas to their caregivers. Therefore, utilizing remote care in the daily workflow would be a valuable tool for the diagnosis and treatment of acute and chronic ocular conditions in this challenging clinical setting. Our aim is to review the latest technological and methodical advances in teleophthalmology and highlight their implementation in screening and managing various ocular conditions. We present them as well as potential diagnostic and treatment applications in view of the recent SARS-CoV-2 virus outbreak. Methods A computerized search from January 2017 up to March 2020 of the online electronic database PubMed was performed, using the following search strings: "telemedicine," "telehealth," and "ophthalmology." More generalized complementary contemporary research data regarding the COVID-19 pandemic was also obtained from the PubMed database. Results A total of 312 records, including COVID-19-focused studies, were initially identified. After exclusion of nonrelevant, non-English, and duplicate studies, a total of 138 records were found eligible. Ninety records were included in the final qualitative analysis. Conclusion Teleophthalmology is an effective screening and management tool for a range of adult and pediatric acute and chronic ocular conditions. It is mostly utilized in screening of retinal conditions such as retinopathy of prematurity, diabetic retinopathy, and age-related macular degeneration; in diagnosing anterior segment condition; and in managing glaucoma. With improvements in image processing, and better integration of the patient's medical record, teleophthalmology should become a more accepted modality, all the more so in circumstances where social distancing is inflicted upon us.

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Accuracy of Detection and Grading of Diabetic Retinopathy and Diabetic Macular Edema Using Teleretinal Screening

Cited by 24 publications

References 33 publications

Implementation of Teleretinal Screening Using Optical Coherence Tomography in the Veterans Health Administration

Implementation of Teleretinal Screening Using Optical Coherence Tomography in the Veterans Health Administration

The Role of Telemedicine, In-Home Testing and Artificial Intelligence to Alleviate an Increasingly Burdened Healthcare System: Diabetic Retinopathy

Telemedicine in ophthalmology in view of the emerging COVID-19 outbreak

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