Philadelphia Telemedicine Glaucoma Detection and Follow-up Study: confirmation between eye screening and comprehensive eye examination diagnoses.
Hark Lisa A, Myers Jonathan S, Ines Andrew, Jiang Alicia, Rahmatnejad Kamran, Zhan Tingting, Leiby Benjamin E, Hegarty Sarah, Fudemberg Scott J, Mantravadi Anand V
AI Summary
Telemedicine glaucoma screening showed high agreement (86%) with comprehensive eye exams, confirming its potential for identifying at-risk individuals for referral, especially for suspicious optic nerves.
Abstract
Aims
To evaluate agreement between ocular findings of a telemedicine eye screening (visit 1) with diagnoses of a comprehensive eye examination (visit 2).
Methods
A primary care practice (PCP)-based telemedicine screening programme incorporating fundus photography, intraocular pressure (IOP) and clinical information was conducted. Eligible individuals were African American, Hispanic/Latino or Asian over the age of 40; Caucasian individuals over age 65; and adults of any ethnicity over age 40 with a family history of glaucoma or diabetes. Participants with abnormal images or elevated IOP were invited back for a complete eye examination. Both visit 1 and visit 2 were conducted at participants' local PCP. Ocular findings at visit 1 and eye examination diagnoses at visit 2 are presented, including a cost analysis.
Results
Of 906 participants who attended visit 1, 536 were invited to visit 2 due to ocular findings or unreadable images. Among the 347 (64.9%) who attended visit 2, 280 (80.7%) were diagnosed with at least one ocular condition. Participants were predominately women (59.9%) and African American (65.6%), with a mean age (±SD) of 60.6±11.0 years. A high diagnostic confirmation rate (86.0%) was found between visit 1 and visit 2 for any ocular finding. Of 183 with suspicious nerves at visit 1, 143 (78.1%) were diagnosed as glaucoma or glaucoma suspects at visit 2.
Conclusions
This screening model may be adapted and scaled nationally and internationally. Referral to an ophthalmologist is warranted if abnormal or unreadable fundus images are detected or IOP is >21 mm Hg.
Trial registration number: NCT02390245.
MeSH Terms
Shields Classification
Key Concepts5
The Philadelphia Telemedicine Glaucoma Detection and Follow-up Study found a high diagnostic confirmation rate (86.0%) between ocular findings from a telemedicine eye screening (visit 1) and diagnoses from a comprehensive eye examination (visit 2) for any ocular finding.
In the Philadelphia Telemedicine Glaucoma Detection and Follow-up Study, among 183 participants with suspicious nerves detected at visit 1 (telemedicine screening), 143 (78.1%) were diagnosed as glaucoma or glaucoma suspects at visit 2 (comprehensive eye examination).
The Philadelphia Telemedicine Glaucoma Detection and Follow-up Study suggests that referral to an ophthalmologist is warranted if abnormal or unreadable fundus images are detected or intraocular pressure (IOP) is greater than 21 mm Hg during telemedicine screening.
A primary care practice (PCP)-based telemedicine screening program, incorporating fundus photography, intraocular pressure (IOP), and clinical information, was conducted for eligible individuals including African American, Hispanic/Latino, or Asian individuals over the age of 40; Caucasian individuals over age 65; and adults of any ethnicity over age 40 with a family history of glaucoma or diabetes.
In the Philadelphia Telemedicine Glaucoma Detection and Follow-up Study, of 906 participants who attended the initial telemedicine screening (visit 1), 536 were invited to a comprehensive eye examination (visit 2) due to ocular findings or unreadable images.
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