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Asia Pac J Ophthalmol (Phila)September 202117 citations

Real-Time Mobile Teleophthalmology for the Detection of Eye Disease in Minorities and Low Socioeconomics At-Risk Populations.

Al-Aswad Lama A, Elgin Cansu Yuksel, Patel Vipul, Popplewell Deborah, Gopal Kalashree, Gong Dan, Thomas Zach, Joiner Devon, Chu Cha-Kai, Walters Stephen


AI Summary

Mobile teleophthalmology effectively screened diverse populations, identifying common eye diseases like glaucoma and cataracts, proving workable for increasing access and early detection.

Abstract

Purpose

To examine the benefits and feasibility of a mobile, real-time, community-based, teleophthalmology program for detecting eye diseases in the New York metro area.

Design

Single site, nonrandomized, cross-sectional, teleophthalmologic study.

Methods

Participants underwent a comprehensive evaluation in a Wi-Fi-equipped teleophthalmology mobile unit. The evaluation consisted of a basic anamnesis with a questionnaire form, brief systemic evaluations and an ophthalmologic evaluation that included visual field, intraocular pressure, pachymetry, anterior segment optical coherence tomography, posterior segment optical coherence tomography, and nonmydriatic fundus photography. The results were evaluated in real-time and follow-up calls were scheduled to complete a secondary questionnaire form. Risk factors were calculated for different types of ophthalmological referrals.

Results

A total of 957 participants were screened. Out of 458 (48%) participants that have been referred, 305 (32%) had glaucoma, 136 (14%) had narrow-angle, 124 (13%) had cataract, 29 had (3%) diabetic retinopathy, 9 (1%) had macular degeneration, and 97 (10%) had other eye disease findings. Significant risk factors for ophthalmological referral consisted of older age, history of high blood pressure, diabetes mellitus, Hemoglobin A1c measurement of ≥6.5, and stage 2 hypertension. As for the ocular parameters, all but central corneal thickness were found to be significant, including having an intraocular pressure >21 mm Hg, vertical cup-to-disc ratio ≥0.5, visual field abnormalities, and retinal nerve fiber layer thinning.

Conclusions

Mobile, real-time teleophthalmology is both workable and effective in increasing access to care and identifying the most common causes of blindness and their risk factors.


MeSH Terms

AgedCross-Sectional StudiesEye DiseasesHumansIntraocular PressureOphthalmologyRisk FactorsSocioeconomic FactorsTelemedicineTomography, Optical Coherence

Key Concepts5

Among 458 referred participants screened by a mobile, real-time teleophthalmology program, 305 (32%) had glaucoma, 136 (14%) had narrow-angle, 124 (13%) had cataract, 29 (3%) had diabetic retinopathy, 9 (1%) had macular degeneration, and 97 (10%) had other eye disease findings.

EpidemiologyCross-sectionalSingle site, nonrandomized, cross-sectional, teleophthalmologic studyn=458 referred participantsCh7Ch8Ch10

Significant risk factors for ophthalmological referral in a mobile, real-time teleophthalmology program included older age, history of high blood pressure, diabetes mellitus, Hemoglobin A1c measurement of ≥6.5, and stage 2 hypertension.

DiagnosisCross-sectionalSingle site, nonrandomized, cross-sectional, teleophthalmologic studyn=957 participantsCh10Ch11

Ocular parameters significant for ophthalmological referral in a mobile, real-time teleophthalmology program included intraocular pressure >21 mm Hg, vertical cup-to-disc ratio ≥0.5, visual field abnormalities, and retinal nerve fiber layer thinning, with central corneal thickness not found to be significant.

DiagnosisCross-sectionalSingle site, nonrandomized, cross-sectional, teleophthalmologic studyn=957 participantsCh3Ch4Ch5Ch6

Mobile, real-time teleophthalmology is both workable and effective in increasing access to care and identifying common causes of blindness and their risk factors in the New York metro area.

MethodologyCross-sectionalSingle site, nonrandomized, cross-sectional, teleophthalmologic studyn=957 participantsCh10Ch28

A mobile, real-time teleophthalmology program in the New York metro area screened 957 participants, identifying 458 (48%) participants who were referred for further evaluation.

MethodologyCross-sectionalSingle site, nonrandomized, cross-sectional, teleophthalmologic studyn=957 participantsCh10

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