Diagnostic Accuracy of Technology-based Eye Care Services

Maa, April Y.; Medert, Charles M.; Lu, Xiaoqin Alexa; Janjua, Rabeea; Howell, Ashley V.; Hunt, Kelly J.; McCord, Sarah; Giangiacomo, Annette; Lynch, Mary G.

doi:10.1016/j.ophtha.2019.07.026

Cited by 43 publications

(33 citation statements)

References 24 publications

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“…A teleophthalmology study conducted at the Veterans Affairs Healthcare System on 256 patients, who underwent tele-screening followed by an in-person in-clinic examination on the same day, showed substantial agreement for cataract and DR diagnosis, followed by glaucoma and AMD in descending order [71]. A 1-year retrospective audit of a teleophthalmology consulting program of 709 patients in western Australia showed that cataract was the most frequent diagnosis (42.7%) followed by glaucoma (11%), AMD (4.4%), and DR (3.8%).…”

Section: Anterior Segmentmentioning

confidence: 99%

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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Section: Anterior Segmentmentioning

confidence: 99%

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

Sommer

Blumenthal

2020

Graefes Arch Clin Exp Ophthalmol

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“…Studies investigating the agreement between community-based optometrists and ophthalmologists based on virtual optic nerve head imaging and visual field images support that idea that community-based screening of at-risk glaucoma patients can reduce the false-positive rate of referral to glaucoma specialists [ 20 , 21 ]. An alternative application of teleglaucoma is large population screening to identify at-risk patients who can then be directed to subspeciality service [ 22 ••, 23 , 24 ]. Validation of such an approach for correctly screening glaucoma patients has been investigated: a study performed at the Atlanta Veterans Affair Hospital confirmed a high rate of agreement for glaucoma/glaucoma suspect diagnoses between face-to-face examination and teleglaucoma evaluation in new patients presenting for comprehensive evaluation [ 22 ••].…”

Section: Teleglaucoma For Screeningmentioning

confidence: 99%

“…An alternative application of teleglaucoma is large population screening to identify at-risk patients who can then be directed to subspeciality service [ 22 ••, 23 , 24 ]. Validation of such an approach for correctly screening glaucoma patients has been investigated: a study performed at the Atlanta Veterans Affair Hospital confirmed a high rate of agreement for glaucoma/glaucoma suspect diagnoses between face-to-face examination and teleglaucoma evaluation in new patients presenting for comprehensive evaluation [ 22 ••]. The ability of teleglaucoma to identify and escalate care for at-risk patients offers significant public health benefits.…”

Section: Teleglaucoma For Screeningmentioning

confidence: 99%

“…Staffieri et al used telemedicine in the screening of first-degree relatives (FDRs) of patients with advanced glaucoma. Two hundred eleven patients were recruited for examination with 6% of FDRs already carrying a diagnosis of glaucoma, and another 21% of patients were identified who either required prompt referral or received a diagnosis of glaucoma suspect or ocular hypertension [ 22 ••]. The Philadelphia Telemedicine Glaucoma Detection and Follow-up Study utilized trained ophthalmic technicians to obtain IOP measurements, anterior segment, and fundus photographs in a primary care setting.…”

Section: Teleglaucoma For Screeningmentioning

confidence: 99%

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The Future Is Now: Incorporating Telemedicine into Glaucoma Care

Ertel

Kahook

Young

2021

Curr Ophthalmol Rep

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Purpose of Review The field of teleglaucoma has expanded rapidly in recent years with several large-scale teleglaucoma screening programs in existence throughout the world. Additionally, teleglaucoma programs for use in disease management are under study. The limited access to care that resulted from the COVID-19 pandemic highlighted the need for expansion of such programs. This article reviews the literature on teleglaucoma for screening and management of glaucoma, discussing considerations for incorporating teleglaucoma into clinical practice. Recent Findings Teleglaucoma screening reduces the rate of false-positive referrals and can accurately screen at-risk populations with accuracy similar to in-person screening. The use of teleglaucoma for the management of glaucoma shows promise for low-risk patients with early disease. Furthermore, teleglaucoma is cost-effective and reduces travel burden for patients resulting in high patient satisfaction. Summary Teleglaucoma offers potential for improving access to glaucoma care, reducing the burden on patients and health care systems.

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“…This method of “store and forward” telemedicine is used most commonly in Diabetic Teleretinal Imaging which aims to reduce blindness from diabetic retinopathy. 6 Diabetic retinopathy is a condition which is often asymptomatic in its initial stages and can lead to vitreous hemorrhages and retinal detachment if uncontrolled. 7 The current method for screening involves a primary care physician's referral to ophthalmologists.…”

Section: T Echnology -B Ased E Ye C Are S Ervices mentioning

confidence: 99%