Use of Joslin Vision Network Digital-Video Nonmydriatic Retinal Imaging to Assess Diabetic Retinopathy in a Clinical Program

Cavallerano, Anthony; Cavallerano, Jerry D.; Katalinic, Paula; Tolson, Ann; Aiello, Lloyd Paul; Aiello, Lloyd M.

doi:10.1097/00006982-200304000-00013

Cited by 91 publications

(65 citation statements)

References 5 publications

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“…Thus, ocular disorders other than DR occur frequently in patients with DM and teleretinal imaging may facilitate their identification. We previously confirmed a high level of agreement between management decisions based on the Joslin Vision Network TM nonmydriatic teleretinal imaging system, clinical exams, and fundus photography [5][6]. In this study, the average length of time between the teleretinal imaging visit and follow-up visit was about 6 months.…”

Section: Discussionsupporting

confidence: 77%

“…The teleretinal imaging system that we used (Joslin Vision Network TM , Joslin Diabetes Center, Boston, Massachusetts) has been described previously [5][6]. Briefly, the imager acquires single-frame video images of three 45° retinal fields using a nonmydriatic retinal camera (TRC NW-5S, Topcon America Corp, Paramus, New Jersey) interfaced to a standard color video camera (Sony 970-MD, Sony Corp, New York, New York).…”

Section: Teleretinal Imaging Protocolmentioning

confidence: 99%

“…The digital teleretinal images were graded stereoscopically for clinical level of DR according to a standardized protocol [5][6]16]. The presence of other ocular, retinal, and choroidal disorders was also recorded.…”

Section: Teleretinal Imaging Protocolmentioning

confidence: 99%

“…Such systems can obtain diagnostic-quality digital retinal images without pupil dilation and highly agree with both 35 mm retinal photography through a dilated pupil and clinical exam by a retina specialist [5][6].…”

Section: Introductionmentioning

confidence: 99%

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Nonmydriatic teleretinal imaging improves adherence to annual eye examinations in patients with diabetes

Conlin¹,

Fisch²,

Cavallerano³

et al. 2006

JRRD

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Abstract-We studied whether nonmydriatic digital retinal imaging with remote interpretation (teleretinal imaging) in the ambulatory care setting affected adherence to annual dilated eye examinations among patients with diabetes. We randomly assigned 448 patients to a teleretinal imaging group or a control group. We measured the number of patients who had dilated eye examinations within 12 months of group assignment and the agreement for level of diabetic retinopathy between teleretinal imaging and the eye examinations. The teleretinal imaging group (n = 223) had significantly more dilated eye examinations than the control group (n = 225). Teleretinal imaging and eye examination results showed significant correlation and moderate agreement. Cataract and smaller pupil size were significantly associated with ungradable retinal images. Two-thirds of patients with ungradable images had other ocular findings. Patients reported high satisfaction with nonmydriatic teleretinal imaging. Nonmydriatic teleretinal imaging improves diabetic retinopathy assessment rates.

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Section: Discussionsupporting

confidence: 77%

Section: Teleretinal Imaging Protocolmentioning

confidence: 99%

Section: Teleretinal Imaging Protocolmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Nonmydriatic teleretinal imaging improves adherence to annual eye examinations in patients with diabetes

Conlin¹,

Fisch²,

Cavallerano³

et al. 2006

JRRD

Self Cite

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show abstract

“…Diabetic retinopathy was diagnosed in 6 diabetic patients with the Joslin Vision Network videodigital retinal imaging system that uses a non-mydriatic retinal fundus camera with low light level imaging without pupil dilatation [28] and has been validated against clinical examination and standard retinal imaging [29]. 2 diabetic subjects had autonomic dysfunction with orthostatic hypotension and 8 diabetes subjects also had cardiac-vagal impairment.…”

Section: A Subjectsmentioning

confidence: 99%

Altered phase interactions between spontaneous blood pressure and flow fluctuations in type 2 diabetes mellitus: Nonlinear assessment of cerebral autoregulation

Peng

Huang

et al. 2008

Physica A: Statistical Mechanics and its Applications

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Cerebral autoregulation (CA) is an important mechanism that involves dilation and constriction in arterioles to maintain relatively s cerebral blood flow in response to changes of systemic blood pressure. Traditional assessments of CA focus on the changes of cerebral blood flow velocity in response to large blood pressure fluctuations induced by interventions. This approach is not feasible for patients with impaired autoregulation or cardiovascular regulation. Here we propose a newly developed technique-the multimodal pressure-flow (MMPF) analysis, which assesses CA by quantifying nonlinear phase interactions between spontaneous oscillations in blood pressure and flow velocity during resting conditions. We show that CA in healthy subjects can be characterized by specific phase shifts between spontaneous blood pressure and flow velocity oscillations, and the phase shifts are significantly reduced in diabetic subjects. Smaller phase shifts between oscillations in the two variables indicate more passive dependence of blood flow velocity on blood pressure, thus suggesting impaired cerebral autoregulation. Moreover, the reduction of the phase shifts in diabetes is observed not only in previously-recognized effective region of CA (<0.1Hz), but also over the higher frequency range from ~0.1 to 0.4Hz. These findings indicate that Type 2 diabetes alters cerebral blood flow regulation over a wide frequency range and that this alteration can be reliably assessed from spontaneous oscillations in blood pressure and blood flow velocity during resting conditions. We also show that the MMPF method has better performance than traditional approaches based on Fourier transform, and is more sui for the quantification of nonlinear phase interactions between nonstationary biological signals such as blood pressure and blood flow.

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Telemedicine and Diabetic Retinopathy

Silva

Cavallerano²,

Aiello³

et al. 2011

Arch Ophthalmol

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Use of Joslin Vision Network Digital-Video Nonmydriatic Retinal Imaging to Assess Diabetic Retinopathy in a Clinical Program

Cited by 91 publications

References 5 publications

Nonmydriatic teleretinal imaging improves adherence to annual eye examinations in patients with diabetes

Nonmydriatic teleretinal imaging improves adherence to annual eye examinations in patients with diabetes

Altered phase interactions between spontaneous blood pressure and flow fluctuations in type 2 diabetes mellitus: Nonlinear assessment of cerebral autoregulation

Telemedicine and Diabetic Retinopathy

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