Ocular telemedicine between Nepal and the USA: prevalence of vitreoretinal disease in rural Nepal

Ulrich, J. Niklas; Poudyal, Govinda; Marks, Steven J.; Vrabec, Tamara R.; Marks, Barry A.; Thapa, A B S; Shresta, M.; Ruit, Sanduk; Federman, Jay L.

doi:10.1136/bjo.2008.151357

Cited by 17 publications

(10 citation statements)

References 18 publications

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“…Fadden et al, 1981;Braun et al, 1997;Wiedman, 1975). Diabetic retinopathy was not found among three known diabetics and two newly diagnosed cases detected while systemic evaluation for retinal vein occlusion in our series, unlike in the previous study done at same district where diabetic retinopathy was present in all two cases (Ulrich et al, 2009). The absence of diabetic retinopathy in our series could be due to the less duration of diabetes, as our known diabetics had a duration of diabetes of less than five years.…”

Section: Discussioncontrasting

confidence: 54%

Vitreo-retinal disorders at high altitude in Nepal

Thapa

Poudyal

et al. 2013

Nep J Oph

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Introduction: Nepal has many mountains including the highest one in the world. People living in high altitude are often involved in climbing mountains. Objective: To explore the pattern of vitreo-retinal disorders at high altitude in Nepal. Materials and methods: Consecutive patients aged 40 years and older who presented at the micro-surgical eye camp at Lukla of Solukhumbu district (2,860 metres) were included. Detailed ocular and systemic histories and ocular examination including dilated fundus evaluation were done. Results: There were a total 81 patients with the mean age of 56.7 years (S.D 11.15). Females (51.9 %) outnumbered males. Sherpa comprised of 76.5 % followed by Rai (9.8 %). The main occupation was agriculture (51.9 %) followed by mountain trekking (28.4 %). Smokers comprised of 13.5 %. Hypertension was the predominant systemic problem (28 %). The best corrected visual acuity of 6/18 and better was found in 86.4 % of cases and less than 3/ 60 in 3.6 % of cases. Age-related macular degeneration (AMD) was found in 19.6 % of cases with a predominant mild AMD (16 %), hypertensive retinopathy in 12.2 %, with grade I hypertensive change in 8.6 %, retinal vein occlusion (RVO) in 7.1 % of cases and with a branch RVO in 4.9 %. Dilated and tortuous retinal vessels were present in 25.9 % of cases; out of this, 9.8 % of the cases had concurrent AMD and/or hypertensive retinopathy. Other retinal problems were macular hole (2.46 %), solar retinopathy (2.46 %) and choroidal tear (1.2 %). Conclusion: AMD, hypertensive retinopathy, and RVO are the main vitreo-retinal disorders besides the dilated and tortuous retinal vessels in people living at high altitude in Nepal.

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Section: Discussioncontrasting

confidence: 54%

Vitreo-retinal disorders at high altitude in Nepal

Thapa

Poudyal

et al. 2013

Nep J Oph

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“…Although the diagnostic abilities of the remote slit lamp were consistent with the conventional slit lamp, the operation of the remote slit lamp is much more time-consuming than the conventional slit lamp. Since this device cannot observe the fundus of the eye, an ocular fundus camera must be combined with the current remote slit lamp for tele-medicine in ophthalmology [14][15][16][17][18].…”

Section: A Summary Of This Examinationmentioning

confidence: 99%

A Remote Operating Slit Lamp Microscope System

Tanabe

Go²,

Sakurada³

et al. 2011

Methods Inf Med

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“…In the past 10 years, a screening method based on digital retinograph acquisition and telemedicine technology has been adopted in developed countries, in large part due to the high potential of this method for improving annual DR screening rates [2,7-12]. However, only a few studies address the DR telemedicine screening experience in underdeveloped countries such as India and Nepal [13,14]. As far as we know, the barriers to DR telemedicine system implementation in underdeveloped countries include relatively little knowledge about DR and poor follow-up compliance among the general diabetic population, poor ophthalmic infrastructure in primary care settings, and deficiency of wireless communication hardware and software to build specific local area networks for data transfer.…”

Section: Introductionmentioning

confidence: 99%

Implementation and first-year screening results of an ocular telehealth system for diabetic retinopathy in China

Peng

Zou

Wang

et al. 2011

BMC Health Serv Res

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BackgroundTo describe implementation and first-year screening results of the first Chinese telehealth system for diabetic retinopathy (DR) - the Beixinjing Community Diabetic Retinopathy Telehealth system (BCDRT).MethodsBCDRT implementation was based on the acquisition of adequate digital retinographs, secure digital transmission, storage and retrieval of participants' data and reader-generated medical reports. Local diabetic residents meeting inclusion criteria were enrolled into the BCDRT system beginning in 2009. Participants recommended for further in-person examination with ophthalmologists were followed, and the consistencies in diagnoses between BCDRT and ophthalmologists for DR or macular edema were calculated.ResultsA total of 471 diabetic residents participated in BCDRT screening in 2009. The proportions of total DR, proliferative DR, and diabetic macular edema were 24.42% (115 patients), 2.12% (10 patients) and 6.47% (24 patients), respectively: 56 patients consulted ophthalmologists for further in-person retinal examination with funduscopy after pupil dilation. High rates of consistency between BCDRT screening and ophthalmologists were observed for macular edema (Kappa = 0.81), moderate or severe non-proliferative DR grade (Kappa = 0.92), and other DR grades (Kappa = 1). A total of 456 (96.82%) patients were willing to participate in the next BCDRT screening.ConclusionsBCDRT was a reliable and valid system for DR screening, and offers the potential to increase DR annual screening rates in local residents.

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Ocular telemedicine between Nepal and the USA: prevalence of vitreoretinal disease in rural Nepal

Cited by 17 publications

References 18 publications

Vitreo-retinal disorders at high altitude in Nepal

Vitreo-retinal disorders at high altitude in Nepal

A Remote Operating Slit Lamp Microscope System

Implementation and first-year screening results of an ocular telehealth system for diabetic retinopathy in China

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