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Igor Kozak, John F Payne, Patrik Schatz, Eman Al-Kahtani, Moritz Winkler
BACKGROUND: To determine the feasibility and efficacy of a retinal telephotocoagulation treatment plan for diabetic macular edema. METHODS: Prospective, interventional cohort study at two clinical sites. Sixteen eyes of ten subjects with diabetic macular edema underwent navigated focal laser photocoagulation using a novel teleretinal treatment plan. Clinic 1 (King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia) collected retinal images and fundus fluorescein angiogram...
April 26, 2017: Graefe's Archive for Clinical and Experimental Ophthalmology
Benjamin Kj Host, Angus W Turner, Josephine Muir
BACKGROUND: Teleophthalmology, particularly real-time video consultation, holds great potential in Australia and similar countries worldwide, where geography, population and medical workforce distribution make it difficult to provide specialist eye services outside of major cities. Assessment and referrals from rural optometrists are vital to the success of teleophthalmology. While there is good evidence for the efficacy of such services, there is limited evidence for patient satisfaction with video consultation...
April 23, 2017: Clinical & Experimental Optometry: Journal of the Australian Optometrical Association
Akhilesh S Pathipati, Darius M Moshfeghi
Teleophthalmology is a developing field that presents diverse opportunities. One of its most successful applications to date has been in pediatric retinal disease, particularly in screening for retinopathy of prematurity (ROP). Many studies have shown that using telemedicine for ROP screening allows a remote ophthalmologist to identify abnormal findings and implement early interventions. Here, we review the literature on uses of telemedicine in pediatric retinal disease and consider future applications.
March 23, 2017: Journal of Clinical Medicine
Shashwat Pathak, Basant Kumar
INTRODUCTION: This article proposes a novel, cost-effective, flexible, and easy-to-deploy wireless teleophthalmology network architecture and performance evaluation for its potential use in remote areas. This study has used practical telecommunication standards, which is widely deployed throughout India. METHODS: In the proposed scenario, patient's eye images are obtained using a specified imaging modality, and then sent to a server at the primary eye care centre (PECC) using ZigBee a short-range wireless network...
March 17, 2017: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
V Swetha E Jeganathan, H Nikki Hall, Roshini Sanders
Ophthalmology departments face intensifying pressure to expedite sight-saving treatments and reduce the global burden of disease. The use of electronic communication systems, digital imaging, and redesigned service care models is imperative for addressing such demands. The recently developed Scottish Eyecare Integration Project involves an electronic referral system from community optometry to the hospital ophthalmology department using National Health Service (NHS) email with digital ophthalmic images attached, via a virtual private network connection...
January 2017: Asia-Pacific Journal of Ophthalmology
Rajvi Mehta, Derek Nankivil, David J Zielinski, Gar Waterman, Brenton Keller, Alexander T Limkakeng, Regis Kopper, Joseph A Izatt, Anthony N Kuo
PURPOSE: Optical coherence tomography (OCT) is widely used in ophthalmology clinics and has potential for more general medical settings and remote diagnostics. In anticipation of remote applications, we developed wireless interactive control of an OCT system using mobile devices. METHODS: A web-based user interface (WebUI) was developed to interact with a handheld OCT system. The WebUI consisted of key OCT displays and controls ported to a webpage using HTML and JavaScript...
January 2017: Translational Vision Science & Technology
Faraz Oloumi, Rangaraj M Rangayyan, Anna L Ells
Retinopathy of prematurity (ROP), a disorder of the retina occurring in preterm infants, is the leading cause of preventable childhood blindness. An active phase of ROP that requires treatment is associated with the presence of plus disease, which is diagnosed clinically in a qualitative manner by visual assessment of the existence of a certain level of increase in the thickness and tortuosity of retinal vessels. The present study performs computer-aided diagnosis (CAD) of plus disease via quantitative measurement of tortuosity in retinal fundus images of preterm infants...
October 2016: Journal of Medical Imaging
Massimo Porta, Francesco Boscia, Paolo Lanzetta, Edoardo Mannucci, Ugo Menchini, Francesca Simonelli
PURPOSE: To evaluate the use of telemedicine retinal screening in Italy and to identify potential elements of implementation of this system. METHODS: Patients with either new-onset diabetes or no ophthalmologic visit over the previous 2 years and attending 33 referral diabetic centers between mid-April 2013 and mid December 2015 were screened. Two partially overlapping nonstereoscopic 45° digital color images were captured from each eye using a fully automated nonmydriatic digital fundus camera...
March 10, 2017: European Journal of Ophthalmology
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...
February 1, 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...
February 2017: Australian Journal of Rural Health
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