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Irene J Tan, Lucy P Dobson, Stephen Bartnik, Josephine Muir, Angus W Turner
INTRODUCTION: Advances in imaging capabilities and the evolution of real-time teleophthalmology have the potential to provide increased coverage to areas with limited ophthalmology services. However, there is limited research assessing the diagnostic accuracy of face-to-face teleophthalmology consultation. This systematic review aims to determine if real-time teleophthalmology provides comparable accuracy to face-to-face consultation for the diagnosis of common eye health conditions. METHODS: A search of PubMed, Embase, Medline and Cochrane databases and manual citation review was conducted on 6 February and 7 April 2016...
July 20, 2016: Journal of Telemedicine and Telecare
Andrea C Coronado, Gregory S Zaric, Janet Martin, Monali Malvankar-Mehta, Francie F Si, William G Hodge
BACKGROUND: Diabetic eye complications are the leading cause of visual loss among working-aged people. Pharmacy-based teleophthalmology has emerged as a possible alternative to in-person examination that may facilitate compliance with evidence-based recommendations and reduce barriers to specialized eye care. The objective of this study was to estimate the cost-effectiveness of mobile teleophthalmology screening compared with in-person examination (primary care) for the diabetic population residing in semiurban areas of southwestern Ontario...
January 2016: CMAJ Open
Lauren Wedekind, Kristin Sainani, Suzann Pershing
Importance: Determining the perceived supply and potential demand for teleophthalmology in emergency departments could help mitigate coverage gaps in emergency ophthalmic care. Objective: To evaluate the perceived current need for and availability of ophthalmologist coverage in California emergency departments and the potential effect of telemedicine for ophthalmology triage and consultation. Design, Setting, and Participants: Surveys were remotely administered to 187 of the 254 emergency departments throughout California via the telephone and Internet from June 30 to September 23, 2014...
March 24, 2016: JAMA Ophthalmology
Elizabeth M Webb, Paul Rheeder, Polla Roux
OBJECTIVE: The aim of the study was to determine the prevalence of diabetic retinopathy, maculopathy and visual loss in primary care patients and to identify associated risk factors. RESEARCH DESIGN AND METHODS: We conducted a cluster randomised trial at primary care clinics in the Tshwane district in South Africa. Grades of retinopathy and maculopathy (with fundus camera) and visual acuity (Snellen chart) were assessed and, using mobile screening and teleophthalmology, clinical and biochemical testing was conducted to obtain information about glycaemic control and microvascular complications...
2016: Ophthalmologica. Journal International D'ophtalmologie
Roderick O'Day, Constance Smith, Josephine Muir, Angus Turner
BACKGROUND: Lions Outback Vision provides a telehealth service ('the telehealth service') to rural and remote communities in Western Australia aiming to deliver timely ophthalmic care to this underserved population. A number of barriers to its use were identified by an initial prospective audit. A multifaceted intervention was designed to increase the use of the telehealth service by optometrists. METHODS: Optometrists referred patients from rural and remote Western Australia to the telehealth service...
March 2016: Clinical & Experimental Optometry: Journal of the Australian Optometrical Association
Taraprasad Das, Rajeev Reddy Pappuru
Diabetic retinopathy (DR) is a growing concern in India. The first step in management of DR is timely screening. With 10% prevalence in rural India, 11 million people are likely to have DR by the year 2030. With limited resources and skilled manpower, it will not be possible to have routine eye examination to identify and treat these patients on a regular basis. Telemedicine is a possible answer in these situations where patients could be remotely screened and appropriately advised. With the advent of several technological advances such as low cost hand-held nonmydriatic camera, increased capabilities of the smartphones to take external eye and retinal photographs coupled with improving broadband connectivity; teleophthalmology in the management of DR could be a reality in the not too distant future...
January 2016: Indian Journal of Ophthalmology
Paolo S Silva, Mark B Horton, Dawn Clary, Drew G Lewis, Jennifer K Sun, Jerry D Cavallerano, Lloyd Paul Aiello
PURPOSE: To compare diabetic retinopathy (DR) identification and ungradable image rates between nonmydriatic ultrawide field (UWF) imaging and nonmydriatic multifield fundus photography (NMFP) in a large multistate population-based DR teleophthalmology program. DESIGN: Multiple-site, nonrandomized, consecutive, cross-sectional, retrospective, uncontrolled imaging device evaluation. PARTICIPANTS: Thirty-five thousand fifty-two eyes (17 526 patients) imaged using NMFP and 16 218 eyes (8109 patients) imaged using UWF imaging...
June 2016: Ophthalmology
Omana Kesary Sreelatha, Sathyamangalam VenkataSubbu Ramesh
Teleophthalmology is gaining importance as an effective eye care delivery modality worldwide. In many developing countries, teleophthalmology is being utilized to provide quality eye care to the underserved urban population and the unserved remote rural population. Over the years, technological innovations have led to improvement in evidence and teleophthalmology has evolved from a research tool to a clinical tool. The majority of the current teleophthalmology services concentrate on patient screening and appropriate referral to experts...
2016: Clinical Ophthalmology
Dawn A Sim, Danny Mitry, Philip Alexander, Adam Mapani, Srini Goverdhan, Tariq Aslam, Adnan Tufail, Catherine A Egan, Pearse A Keane
Modern ophthalmic practice in the United Kingdom is faced by the challenges of an aging population, increasing prevalence of systemic pathologies with ophthalmic manifestations, and emergent treatments that are revolutionary but dependent on timely monitoring and diagnosis. This represents a huge strain not only on diagnostic services but also outpatient management and surveillance capacity. There is an urgent need for newer means of managing this surge in demand and the socioeconomic burden it places on the health care system...
March 2016: Journal of Diabetes Science and Technology
Brian C Toy, David J Myung, Lingmin He, Carolyn K Pan, Robert T Chang, Alison Polkinhorne, Douglas Merrell, Doug Foster, Mark S Blumenkranz
PURPOSE: To compare clinical assessment of diabetic eye disease by standard dilated examination with data gathered using a smartphone-based store-and-forward teleophthalmology platform. METHODS: 100 eyes of 50 adult patients with diabetes from a health care safety-net ophthalmology clinic. All patients underwent comprehensive ophthalmic examination. Concurrently, a smartphone was used to estimate near visual acuity and capture anterior and dilated posterior segment photographs, which underwent masked, standardized review...
May 2016: Retina
Paolo S Silva, Jerry D Cavallerano, Nour Maya N Haddad, Dorothy Tolls, Komal Thakore, Bina Patel, Mina Sehizadeh, Ann M Tolson, Jennifer K Sun, Lloyd Paul Aiello
IMPORTANCE: Ultrawide field imaging (UWFI) is increasingly being used in teleophthalmology settings. Given the greater area of the retina imaged, we evaluated the ability of UWFI vs nonmydriatic fundus photography (NMFP) to detect nondiabetic retinal findings in a teleophthalmology program. OBSERVATION: We conducted a retrospective single-center comparative cohort study from January 1, 2011, to June 30, 2013, imaging 3864 and 3971 consecutive teleophthalmology patients (7728 and 7942 eyes) using NMFP and UWFI, respectively...
March 2016: JAMA Ophthalmology
Hessom Razavi, Stephen Paul Copeland, Angus Warwick Turner
PROBLEM: Despite its potential to improve service provision for country patients, teleophthalmology is currently underused in Australia. There is an associated lack of cost-effectiveness data for teleophthamology. DESIGN: Retrospective and prospective hospital-based clinical audits of 5456 patients; descriptive survey of available telehealth equipment in 129 regional facilities; cost calculations for teleophthalmology, patient transfers and outreach services. SETTING: Primary (optometry, general practice [GP], Aboriginal Medical Service [AMS]) and secondary (hospital) sites in regional Western Australia; a tertiary hospital in Perth...
January 19, 2016: Australian Journal of Rural Health
Yufeng Ye, Jianhua Wang, Yanan Xie, Hong Jiang, Jianguang Zhong, Xiaojian He, Huicheng Zhang
PURPOSE: This study aimed to determine the feasibility and quality of real-time video transferring in global teleophthalmology using two smartphones during microscopic ocular surgery. METHODS: An iPhone 4S (Apple) was adapted into a surgical microscope in Hangzhou, Zhejiang, China to capture video during microscopic ocular surgery. An iPhone 5 (Apple), an iPad2 (Apple), and a desktop computer were used as the receptor on the other side of the globe (Miami, FL). A standard resolution test card and the three surgeries of human eyes were captured...
September 2016: Eye & Contact Lens
Faraz Oloumi, Rangaraj M Rangayyan, Paola Casti, Anna L Ells
Changes in the characteristics of retinal vessels such as width and tortuosity can be signs of the presence of several diseases such retinopathy of prematurity (ROP) and diabetic retinopathy. Plus disease is an indicator of ROP which requires treatment and is signified by an increase in posterior venular width. In this work, we present image processing techniques for the detection, segmentation, tracking, and measurement of the width of the major temporal arcade (MTA), which is the thickest venular branch in the retina...
November 1, 2015: Computers in Biology and Medicine
Elias Chelala, Nadine Saleh, Ali Dirani, Ali Fadlallah, Patrick Baz, Elise Slim, Georges Halaby, Riad Bejjani
PURPOSE: Diabetes and diabetic retinopathy (DR) are nowadays a major public health threat. The aim of this study is the screening of DR and diabetic maculopathy (DM) in a primary medical care center in Lebanon. We study also the interest of retinography and of SD-OCT in a telemedicine screening program. METHODS: This is a transversal study of patients with type 2 diabetes and with a regular follow-up in a primary medical care center in Beirut. For every patient, a retinography and an SD-OCT of the macula were obtained...
April 2015: Le Journal Médical Libanais. the Lebanese Medical Journal
Paolo S Silva, Jerry D Cavallerano, Ann M Tolson, Jessica Rodriguez, Sashida Rodriguez, Radwan Ajlan, Dorothy Tolls, Bina Patel, Mina Sehizadeh, Komal Thakore, Jennifer K Sun, Lloyd Paul Aiello
OBJECTIVE: To evaluate the ability of trained nonphysician retinal imagers to perform diabetic retinopathy (DR) evaluation at the time of ultrawide field retinal (UWF) imaging in a teleophthalmology program. RESEARCH DESIGN AND METHODS: Clinic patients with diabetes received Joslin Vision Network protocol retinal imaging as part of their standard medical care. Retinal imagers evaluated UWF images for referable DR at the time of image capture. Training of the imagers included 4 h of standardized didactic lectures and 12 h of guided image review...
September 2015: Diabetes Care
Karim A Johnson, Joos Meyer, Seyhan Yazar, Angus W Turner
OBJECTIVE: This study aims to assess the current utilisation of a real-time teleophthalmology service for rural Western Australia (WA). DESIGN: Service evaluation by prospective audit. SETTING: Includes general practices, optometrists, hospitals in rural WA and the Lions Eye Institute in Perth. PARTICIPANTS: Eighty-five patients from rural WA participating. INTERVENTIONS: Video consultation (VC) with a general ophthalmologist...
June 2015: Australian Journal of Rural Health
Guillermo Martínez Pérez, Wayne Swart, Jimmy Kondwani Munyenyembe, Peter Saranchuk
INTRODUCTION: Malawi has one of the highest HIV prevalences in Sub-Saharan Africa. The rate of eligible HIV-infected people being initiated on antiretroviral therapy (ART) and retained in HIV-care is currently far from adequate. Consequently, many people continue present with advanced immunosuppression at public health facilities, often with undiagnosed opportunistic infections (OIs). METHODS: In this context, mHealth was the innovation chosen to assist Eye Clinical Officers in early diagnosis of HIV-related diseases having eye manifestations in a rural hospital in Thyolo, Southern Malawi...
2014: Pan African Medical Journal
Julie Kim, D Dean Driver
BACKGROUND: Access to health services is a particular challenge for First Nations (aboriginal Canadians) communities living in remote or underserviced areas. Teleophthalmology can provide them with the same level of retinal screening services provided to those in urban centers. This screening can lead to the identification of high-risk individuals who can then be monitored and receive treatment related to their diabetes or other health issues. OBJECTIVE: The intent was to develop, implement, and evaluate a service delivery model for teleophthalmology screening and follow-up for at-risk and diabetic First Nations clients on Vancouver Island, British Columbia, Canada...
2015: JMIR Medical Informatics
Imran Jivraj, Chris J Rudnisky, Emmanuel Tambe, Graham Tipple, Matthew T S Tennant
Purpose. Congenital rubella syndrome (CRS) is a global cause of preventable hearing impairment, blindness, and intellectual impairment. The present study sought to identify ocular and auditory manifestations of CRS in school-aged children in Mbingo, Cameroon. Design. Cross sectional study. Subjects. Students at two schools, one for children with hearing impairment, were screened for cataract, congenital glaucoma, and pigmentary retinopathy. Methods. Students underwent seven-field digital fundus photography through a dilated pupil using a Topcon NW200 nonmydriatic camera...
2014: International Journal of Telemedicine and Applications
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