Nonmydriatic Digital Imaging Alternative for Annual Retinal Examination in Persons With Previously Documented No or Mild Diabetic Retinopathy

Cavallerano, Jerry D.; Aiello, Lloyd Paul; Cavallerano, Anthony; Katalinic, Paula; Hock, Kristen; Kirby, Rita; Aiello, Lloyd M.

doi:10.1016/j.ajo.2005.03.075

Cited by 56 publications

(44 citation statements)

References 14 publications

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“…Non-mydriatic photography is thus very useful in screening for DR, though it does not currently meet the stringent National Institute for Clinical Excellence guidelines 28 . Recent studies suggest this may be changing 370 . Sensitivity >60% may be adequate 364 .…”

Section: Non-mydriatic (Undilated) Photographymentioning

confidence: 99%

“…Good macular stereoscopic photographs are difficult to obtain without pupil dilation 369 ; and without stereoscopic views, CSME may be difficult to detect when few exudates are present. The Joslin Vision Network Study (52 patients) suggested recent improvement, with only 3% ungradeable for DME 370 . A new technique employing stereoscopic non-mydriatic photography was reported to provide excellent agreement with a dilated ophthalmic retinal examination in a large sample (280 patients) 371 .…”

Section: Non-mydriatic (Undilated) Photographymentioning

confidence: 99%

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Adherence to diabetic eye examination guidelines in Australia: the National Eye Health Survey

Foreman

Keel

Xie

et al. 2017

Medical Journal of Australia

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Section: Non-mydriatic (Undilated) Photographymentioning

confidence: 99%

Section: Non-mydriatic (Undilated) Photographymentioning

confidence: 99%

Adherence to diabetic eye examination guidelines in Australia: the National Eye Health Survey

Foreman

Keel

Xie

et al. 2017

Medical Journal of Australia

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“…If diabetic retinopathy or macular edema could not be fully assessed, the investigators would grade the images as ''too poor to grade.'' 25 The investigators entered all information into electronic forms within the telemedicine system. The telemedicine system automatically created and e-mailed the evaluation report to the staff at the clinic.…”

Section: Telemedicine Groupmentioning

confidence: 99%

Comparing the Effectiveness of Telemedicine and Traditional Surveillance in Providing Diabetic Retinopathy Screening Examinations: A Randomized Controlled Trial

Mansberger

Gleitsmann

Gardiner

et al. 2013

Telemedicine and e-Health

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The protocol of this study is registered as ''The Comparative Effectiveness of Telemedicine to Detect Diabetic Retinopathy'' with ClinicalTrials.gov having clinical trial registration number NCT01364129. The findings and conclusions in this article are those of the author(s) and do not necessarily represent the official position of the Centers for Disease Control and Prevention. The sponsor or funding organization had no role in the design or conduct of this research. AbstractObjective: To determine the effectiveness of telemedicine for providing diabetic retinopathy screening examinations compared with the effectiveness of traditional surveillance in community health clinics with a high proportion of minorities, including American Indian/Alaska Natives. Subjects and Methods: We conducted a multicenter, randomized controlled trial and assigned diabetic participants to one of two groups: (1) telemedicine with a nonmydriatic camera or (2) traditional surveillance with an eye care provider. For those receiving telemedicine, the criteria for requiring follow-up with an eye care provider were (1) moderate nonproliferative diabetic retinopathy or higher, (2) presence of clinically significant macular edema, or (3) ''unable to grade'' result for diabetic retinopathy or macular edema. Results: The telemedicine group (n = 296) was more likely to receive a diabetic retinopathy screening examination within the first year of enrollment compared with the traditional surveillance group (n = 271) (94% versus 56%, p < 0.001). The overall prevalence of diabetic retinopathy at baseline was 21.4%, and macular edema was present in 1.4% of participants. In the telemedicine group, 20.5% would require further evaluation with an eye care provider, and 86% of these referrals were because of poorquality digital images. Conclusions: Telemedicine using nonmydriatic cameras increased the proportion of participants who obtained diabetic retinopathy screening examinations, and most did not require follow-up with an eye care provider. Telemedicine may be a more effective way to screen patients for diabetic retinopathy and to triage further evaluation with an eye care provider. Methods to decrease poor quality imaging would improve the effectiveness of telemedicine for diabetic retinopathy screening examinations.

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“…In a series of studies, a significant level of agreement has been shown for the level of DR and for the presence of referable eye diseases between digital retinal imaging and subsequent comprehensive eye examinations performed by eye care professionals. 15,21,26 Digital retinal imaging also frequently identifies nondiabetic ocular pathology, 15 although there are fewer studies validating this additional feature. A second major benefit of the program occurs during the imaging encounter, when the imager/care coordinator has an opportunity to provide basic education to the patient relating to causes and prevention of diabetes-related eye complications and preservation of vision.…”

Section: Benefits Of the Teleretinal Imaging Eye Care Programmentioning

confidence: 99%

“…15,23,26 Images comprising three 45° fields are captured for each eye: nonmydriatic image (NM)-1, centering the macula and including the optic disk; NM-2, encompassing the superior temporal vascular arcade; and NM-3, covering an area of the retina nasal to the optic disk with a slight emphasis toward the inferior quadrant. Additionally, an external image is captured for gross evaluation of the lids, lashes, and periocular region.…”

Section: Obtaining Digital Retinal Imagesmentioning

confidence: 99%

Teleretinal Imaging to Screen for Diabetic Retinopathy in the Veterans Health Administration

Cavallerano

Conlin

2008

J Diabetes Sci Technol

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Diabetes is the leading cause of adult vision loss in the United States and other industrialized countries. While the goal of preserving vision in patients with diabetes appears to be attainable, the process of achieving this goal poses a formidable challenge to health care systems. The large increase in the prevalence of diabetes presents practical and logistical challenges to providing quality care to all patients with diabetes. Given this challenge, the Veterans Health Administration (VHA) is increasingly using information technology as a means of improving the efficiency of its clinicians. The VHA has taken advantage of a mature computerized patient medical record system by integrating a program of digital retinal imaging with remote image interpretation (teleretinal imaging) to assist in providing eye care to the nearly 20% of VHA patients with diabetes. We describe this clinical pathway for accessing patients with diabetes in ambulatory care settings, evaluating their retinas for level of diabetic retinopathy with a teleretinal imaging system, and prioritizing their access into an eye and health care program in a timely and appropriate manner.

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Nonmydriatic Digital Imaging Alternative for Annual Retinal Examination in Persons With Previously Documented No or Mild Diabetic Retinopathy

Cited by 56 publications

References 14 publications

Adherence to diabetic eye examination guidelines in Australia: the National Eye Health Survey

Adherence to diabetic eye examination guidelines in Australia: the National Eye Health Survey

Comparing the Effectiveness of Telemedicine and Traditional Surveillance in Providing Diabetic Retinopathy Screening Examinations: A Randomized Controlled Trial

Teleretinal Imaging to Screen for Diabetic Retinopathy in the Veterans Health Administration

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