Philadelphia Telemedicine Glaucoma Detection and Follow-up Study: confirmation between eye screening and comprehensive eye examination diagnoses. Issue 12 (15th February 2019)

• Record Type: Journal Article
• Authors: 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; Waisbourd, Michael; Henderer, Jeffrey D; Burns, Christine; Divers, Meskerem; Molineaux, Jeanne; Pizzi, Laura T; Murchison, Ann P; Saaddine, Jinan; Pasquale, Louis R; Haller, Julia A; Katz, L Jay
• Is Part Of: British journal of ophthalmology. Volume 103:Issue 12(2019)
• Page Start: 1820
• Page End: 1826
• Publication Date: 2019-02-15
• Subjects: Telemedicine -- Glaucoma -- Diagnostic tests/Investigation -- Intraocular pressure -- Public health; Ophthalmology -- Periodicals; 617.7
• DOI: 10.1136/bjophthalmol-2018-313451
• Languages: English
• ISSNs: 0007-1161

Abstract

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 .