Philadelphia Telemedicine Glaucoma Detection and Follow-up Study: Methods and Screening Results.
Publication/Presentation Date
9-1-2017
Abstract
PURPOSE: To describe methodology and screening results from the Philadelphia Telemedicine Glaucoma Detection and Follow-up Study.
DESIGN: Screening program results for a prospective randomized clinical trial.
METHODS: Individuals were recruited who were African-American, Hispanic/Latino, or Asian over age 40 years; white individuals over age 65 years; and any ethnicity over age 40 years with a family history of glaucoma or diabetes. Primary care offices and Federally Qualified Health Centers were used for telemedicine (Visit 1). Two posterior fundus photographs and 1 anterior segment photograph were captured per eye in each participant, using a nonmydriatic, autofocus, hand-held fundus camera (Volk Optical, Mentor, Ohio, USA). Medical and ocular history, family history of glaucoma, visual acuity, and intraocular pressure measurements using the ICare rebound tonometer (ICare, Helsinki, Finland) were obtained. Images were read remotely by a trained retina reader and a glaucoma specialist.
RESULTS: From April 1, 2015, to February 6, 2017, 906 individuals consented and attended Visit 1. Of these, 553 participants were female (61.0%) and 550 were African-American (60.7%), with a mean age of 58.7 years. A total of 532 (58.7%) participants had diabetes, and 616 (68%) had a history of hypertension. During Visit 1, 356 (39.3%) participants were graded with a normal image. Using image data from the worse eye, 333 (36.8%) were abnormal and 155 (17.1%) were unreadable. A total of 258 (28.5%) had a suspicious nerve, 62 (6.8%) had ocular hypertension, 102 (11.3%) had diabetic retinopathy, and 68 (7.5%) had other retinal abnormalities.
CONCLUSION: An integrated telemedicine screening intervention in primary care offices and Federally Qualified Health Centers detected high rate of suspicious optic nerves, ocular hypertension, and retinal pathology.
Volume
181
First Page
114
Last Page
124
ISSN
1879-1891
Published In/Presented At
Hark, L. A., Katz, L. J., Myers, J. S., Waisbourd, M., Johnson, D., Pizzi, L. T., Leiby, B. E., Fudemberg, S. J., Mantravadi, A. V., Henderer, J. D., Zhan, T., Molineaux, J., Doyle, V., Divers, M., Burns, C., Murchison, A. P., Reber, S., Resende, A., Bui, T. D. V., Lee, J., … Haller, J. A. (2017). Philadelphia Telemedicine Glaucoma Detection and Follow-up Study: Methods and Screening Results. American journal of ophthalmology, 181, 114–124. https://doi.org/10.1016/j.ajo.2017.06.024
Disciplines
Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods
PubMedID
28673747
Department(s)
Administration and Leadership
Document Type
Article