Telemedizinisch unterstütztes Screening der retinalen Gefäße („Talking Eyes”)

Michelson, G.; Groh, Michael J. M.; Baleanu, D.; Harazny, J.; Horstmann, R.; Kolominsky-Rabas, Peter

doi:10.1055/s-2005-857941

Cited by 14 publications

(4 citation statements)

References 2 publications

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“…All participants underwent a medical interview that included general medical, ocular medical, and family history. Age, gender, presence of arterial hypertension, diabetes mellitus or any other systemic diseases, and incident stroke were registered [12]. …”

Section: Methodsmentioning

confidence: 99%

The Role of Retinal Vascular Density as a Screening Tool for Ageing and Stroke

et al. 2018

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Objectives: To measure the density of retinal vessels from digitized fundus photographs in patients with recent stroke and age-matched controls. To investigate whether the parameter retinal vascular density (RVD) served as a quantitative marker for cerebrovascular events. Methods: Digitized fundus photographs of n = 158 subjects with stroke or transient ischemic attack within 1 year at the time of examination and n = 1,250 age-matched controls without any remarkable medical history were examined. Sex, hypertension, and diabetes were considered to be cofactors. Measurement of RVD was performed with a computer-aided image-analyzing program by segmenting automatically all visible retinal vessels and measuring areas of vessels in distinct circles around the optic disk. Results: In controls RVD dwindles with increasing distance from the optic disk. RVD decreased significantly with age (p = 0.000). Stroke patients showed significantly lower values of RVD of –15% in comparison to age-matched controls. In old subjects, stroke in combination with hypertension is associated with a significant decreased RVD, and in middle-aged subjects diabetes and stroke are associated with a significant decreased RVD (p = 0.01). Conclusion: Age and stroke are significant risk factors for decreased RVD. Diabetes and arterial hypertension are additional significant risk factors in patients with stroke with respect to RVD.

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Section: Methodsmentioning

confidence: 99%

The Role of Retinal Vascular Density as a Screening Tool for Ageing and Stroke

et al. 2018

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“…Because we refrained from using a mydriatic agent to dilate patients’ pupils, participants were placed in a darkened room for 5 min prior to the photograph in order to widen pupils through dark adaptation. The images were uploaded to the cloud-based software MedStage (Siemens, Medical Product, class IIa, Talkingeyes & More, Erlangen)16 17 and saved in the MedStage-patient chart. An experienced senior ophthalmologist (GM from Department of Ophthalmology Friedrich-Alexander University Erlangen-Nürnberg) classified—using a standardised protocol through the Tele-Ophthalmic Consultation Service Talkingeyes (Talkingeyes & More)—the pictures into three different fundus categories: no or mild vascular retinopathy, moderate vascular retinopathy and vascular retinopathy with vessel rarefaction.…”

Section: Methodsmentioning

confidence: 99%

Retinal microvascular signs and recurrent vascular events in patients with TIA or minor stroke

et al. 2023

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Background and purposeRetinal pathologies are an independent risk factor for ischaemic stroke, but research on the predictive value of retinal abnormalities for recurrent vascular events in patients with prior stroke is inconclusive. We investigated the association of retinal pathologies with subsequent vascular events.MethodsIn a substudy of the Intensified secondary prevention intending a reduction of recurrent events in TIA and minor stroke patients (INSPiRE-TMS) trial, we enrolled patients with recent transient ischaemic attack (TIA) or minor stroke with at least one modifiable risk factor. Primary outcome was the composite of subsequent vascular events. Retinal photographs were taken at baseline and categorised into three different fundus groups by a telemedically linked ophthalmologist.Results722 patients participated in the current study and 109 major vascular events occurred. After multivariable adjustments, we did not find a significant association between fundus categories and risk for subsequent vascular events (HRs for moderate vascular retinopathy and vascular retinopathy with vessel rarefaction in comparison to no vascular retinopathy 1.03 (95% CI 0.64 to 1.67), p=0.905 and 1.17 (95% CI 0.62 to 2.20), p=0.626). In a selective post hoc analysis in patients with diabetes mellitus and hypertension, patients with vascular retinopathy with vessel rarefaction had a higher risk for recurrent stroke (HR 24.14 (95% CI 2.74 to 212.50), p=0.004).ConclusionsRetinal changes did not predict major subsequent vascular events in patients with recent TIA or minor stroke. Further studies are needed to examine the utility of fundus photography in assessing the risk of stroke recurrence in patients with diabetes mellitus and hypertension.

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“…In den vergangenen 20 Jahren ist die Ophthalmologie allgemein bemüht, ergänzend zu deskriptiv beschreibenden Befunden quantitative und objektive Messwerte für die Diagnostik und Verlaufsbeurteilung zu erheben. Für retinale Gefäßdurchmesser konnten so in grçßeren epidemiologischen Studien Zusammenhänge zu Inzidenz [10,15] und Prävalenz des arteriellen Hypertonus [5,13], zur Schlaganfallprävalenz [12], Angina pectoris [6] sowie zu weiteren kardiovaskulären Risikofaktoren [3] nachgewiesen werden. Die Mçglichkeiten der digitalen Fundusfotografie und eine weitgehend automatisierte Auswertung [7] ermçglichen heute die Bestimmung von Gefäßdurchmessern in der klinischen Routine.…”

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“…Die Mçglichkeiten der digitalen Fundusfotografie und eine weitgehend automatisierte Auswertung [7] ermçglichen heute die Bestimmung von Gefäßdurchmessern in der klinischen Routine. Gerade unter den Alltagsbedingungen der Praxis wie auch von Screeninguntersuchungen [6] [12]: Der Untersucher markiert die Lage der Papille im Bild, nachfolgend wird von der Software der Auswertebereich vorgegeben. Innerhalb dieses Bereiches ordnet der Untersucher durch Mausklick alle methods for both the coefficient of variation of CRVE (1.9 %; 1.8 %; 1.7 %) and the average values of CRAE, CRVE and AVR.…”

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