Practice Guidelines for Ocular Telehealth-Diabetic Retinopathy, Third Edition

Horton, Mark B.; Brady, Christopher J.; Cavallerano, Jerry D.; Abràmoff, Michael D.; Barker, Gail; Chiang, Michael F.; Crockett, Charlene; Garg, Seema; Karth, Peter A.; Liu, Yao; Newman, Clark D; Rathi, Sonika; Sheth, Veeral; Silva, Paolo; Stebbins, Kristen; Zimmer-Galler, Ingrid

doi:10.1089/tmj.2020.0006

Cited by 58 publications

(53 citation statements)

References 223 publications

(246 reference statements)

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“…As the preceding discussion illustrates, the ocular telehealth paradigm for ROP is different from remote screening for diabetic retinopathy (DR) as discussed in the current edition of the American Telemedicine Association (ATA) Practice Guidelines for Ocular Telehealth-Diabetic Retinopathy. 69 The population at risk is hospitalized low-birth weight premature infants, so the technical aspects of image acquisition need to account for the NICU environment and the anatomy of the neonatal eye. For ROP, the burden of screening largely falls on the providers and health systems rather than on patients to present for opportunistic screening.…”

Section: Discussionmentioning

confidence: 99%

“…Different groups have used different diagnostic set points as already discussed, so any program must validate to their predetermined level of disease severity, analogous to the recommendations made in the 3rd Edition of the ATA Practice Guidelines for Ocular Telehealth-Diabetic Retinopathy. 69 The majority of research to date has used contact wide-field imaging, but research is ongoing to determine the value of noncontact posterior pole imaging to detect plus disease to screen for RW-ROP. 70 Because the volume of babies requiring imaging in a given center may be lower than what is seen in DR screening, deliberate efforts should be taken so that imagers maintain skills.…”

Section: Discussionmentioning

confidence: 99%

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Telemedicine for Retinopathy of Prematurity

Brady

D'Amico

Campbell

2020

Telemedicine and e-Health

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Background: Retinopathy of prematurity (ROP) is a disease of the retinal vasculature that remains a leading cause of childhood blindness worldwide despite improvements in the systemic care of premature newborns. Screening for ROP is effective and cost-effective, but in many areas, access to skilled examiners to conduct dilated examinations is poor. Remote screening with retinal photography is an alternative strategy that may allow for improved ROP care. Methods: The current literature was reviewed to find clinical trials and expert consensus documents on the state-of-the-art of telemedicine for ROP. Results: Several studies have confirmed the utility of telemedicine for ROP. In addition, several clinical studies have reported favorable long-term results. Many investigators have reinforced the need for detailed protocols on image acquisition and image interpretation. Conclusions: Telemedicine for ROP appears to be a viable alternative to live ophthalmoscopic examinations in many circumstances. Standardization and documentation afforded by telemedicine may provide additional benefits to providers and their patients. With continued improvements in image quality and affordability of imaging systems as well as improved automated image interpretation tools anticipated in the near future, telemedicine for ROP is expected to play an expanding role for a uniquely vulnerable patient population.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Telemedicine for Retinopathy of Prematurity

Brady

D'Amico

Campbell

2020

Telemedicine and e-Health

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“…Telemedicine has been used in ophthalmology in different aspects including mainly the screening and diagnosis of diabetic retinopathy, 18 but also the diagnosis of retinopathy of prematurity (ROP) by using trained nonexpert personnel to capture images and transfer data to remote ophthalmologists, 19 as well as in glaucoma and other eye diseases. 20 Teleophthalmology has been previously described in patients with AMD requiring IVI.…”

Section: Discussionmentioning

confidence: 99%

<p>Hybrid Telehealth Medical Retina Clinic Due to Provider Exposure and Quarantine During COVID-19 Pandemic</p>

Aweidah¹,

Safadi²,

Jotkowitz³

et al. 2020

OPTH

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To present our hybrid telehealth medical retina clinic service with intravitreal injections (IVI) treatment as a safe alternative to in-person visits and examination during COVID-19 pandemic disease. Methods: Due to exposure to a COVID-19 positive retina fellow, our retina service, in quarantine, evaluated patients' medical files and retinal scans using a telemedicine approach. A different protocol for patients coming for IVI during the COVID-19 pandemic was established for IVI administration. Results: During the 14-day quarantine period (between March 18th and March 31st 2020), the hybrid telehealth medical retina clinic performed 523 IVI to 394 patients with a mean age ± SD 70.96 ± 14.4 years. IVI were administered for neovascular age-related macular degeneration in 50.5% of the cases (199 patients), diabetic macular edema in 21.3% (84 patients), retinal vein occlusion in 17.5% (69 patients), and 10.7% for other retinal pathologies (42 patients). No ocular or systemic complications were observed. Conclusion: During disasters and pandemics, IVI can be provided safely using a hybrid telehealth medical retina clinic approach but only in the appropriate patient and health care system.

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“…The aforementioned examples illustrate how teleophthalmology can be utilized in order to reduce clinic crowding, reduce administrative purpose encounters, and remotely triage and identify those patients requiring an in-person examination. Given the considerable weight of telemedicine applications in various aspects of DR, a working group of a large number of experts in clinical applications for telehealth in ophthalmology, known as the Diabetic Retinopathy Telehealth Practice Guidelines Working Group, recently published an updated guideline for implementing and operating telehealth services for DR in a broad range of clinical settings [29].…”

Section: Diabetic Retinopathymentioning

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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Practice Guidelines for Ocular Telehealth-Diabetic Retinopathy, Third Edition

Cited by 58 publications

References 223 publications

Telemedicine for Retinopathy of Prematurity

Telemedicine for Retinopathy of Prematurity

<p>Hybrid Telehealth Medical Retina Clinic Due to Provider Exposure and Quarantine During COVID-19 Pandemic</p>

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

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