Optometry - Journal of the American Optometric Association
Clinical researchDetection of glaucoma-like optic discs in a diabetes teleretinal program
Section snippets
Methods
This is a retrospective observational study of 1,644 patients with DM who were accessed consecutively from May 2002 to March 2004 as part of a Diabetes Teleretinal Program. The Institutional Review Board and Research and Development Committee at VA Boston Healthcare System approved this study.
Patients with DM who did not have a record of a comprehensive eye examination within the previous 11 months were accessed for digital retinal imaging when they presented to 2 ambulatory care clinics.
Results
Review of the teleretinal imaging reports on patients in group 1 indicated readers made their determination of glaucoma suspect for the following reasons: suspicious cupping, CDR asymmetry, neuroretinal rim excavation, or thinning. In no instance did the readers comment that they found a disc hemorrhage or that the nerve fiber layer was defective. For patients identified as glaucoma suspects (group 1), readers were able to evaluate 157 of 175 (90%) for level of DR. For patients not regarded as
Discussion
Previous reports indicate that NMDRI is effective for diagnosing level of DR.20, 22, 24 Additionally, although not validated in rigorous prospective trials, NMDRI has the potential to detect other important ocular and systemic-related conditions. Our findings suggest that NMDRI is a useful tool for identifying optic nerve head findings suspicious for glaucoma in a primary care setting, although formalized grading strategies are needed to maximize the ability to detect glaucoma-suspicious optic
Acknowledgments
This work was presented in part at the 2005 American Telemedicine Association meeting, April 18, 2005, in Denver, Colorado. The authors have no financial interest related to this article.
This work was supported by the Department of Defense grant (Conlin).
References (35)
Blindness in patients with treated open-angle glaucoma
Ophthalmology
(2003)- et al.
Open-angle glaucoma and diabetes: the Blue Mountains eye study, Australia
Ophthalmology
(1997) - et al.
Primary open-angle glaucoma, intraocular pressure, and diabetes mellitus in the general elderly populationThe Rotterdam Study
Ophthalmology
(1996) - et al.
Open-angle glaucoma and older-onset diabetesThe Beaver Dam Eye Study
Ophthalmology
(1994) - et al.
Risk factors for primary open angle glaucoma
Am J Prev Med
(1988) - et al.
Prospective study of type 2 diabetes mellitus and primary open-angle glaucoma in women
Ophthalmology
(2006) - et al.
Diabetes, intraocular pressure, and primary open-angle glaucoma in the Baltimore Eye Survey
Ophthalmology
(1995) - et al.
Is diabetes mellitus a risk factor for open-angle glaucoma?The Rotterdam Study
Ophthalmology
(2006) - et al.
Use of telemedicine in screening for diabetic retinopathy
Can J Ophthalmol
(2003) - et al.
Screening for diabetic retinopathy: the first telemedical approach in a primary care setting in France
Diabetes Metab
(2004)
Stereo nonmydriatic digital-video color retinal imaging compared with Early Treatment Diabetic Retinopathy Study seven standard field 35-mm stereo color photos for determining level of diabetic retinopathy
Ophthalmology
Effectiveness and safety of screening for diabetic retinopathy with two nonmydriatic digital images compared with the seven standard stereoscopic photographic fields
Can J Ophthalmol
The number of people with glaucoma worldwide in 2010 and 2020
Br J Ophthalmol
Direct costs of glaucoma and severity of the disease: a multinational long term study of resource utilisation in Europe
Br J Ophthalmol
Glaucoma risk factors in primary open-angle glaucoma patients compared to ocular hypertensives and control subjects
Korean J Ophthalmol
Diabetes mellitus as a risk factor for primary open-angle glaucoma: a meta-analysis
Diabet Med
Cited by (22)
Anterior Segment and Others in Teleophthalmology: Past, Present, and Future
2021, Asia-Pacific Journal of OphthalmologyTeleophthalmology for the elderly population: A review of the literature
2020, International Journal of Medical InformaticsCitation Excerpt :International population-based studies show that approximately 50 % of diabetic individuals do not regularly undergo screening for DR [9]. For people with glaucoma, a major cause of vision loss is a delayed presentation [10]. AMD patients also may exhibit high rates of recurrence and visual deterioration after the conclusion of their treatment [11].
Early Experience with Technology-Based Eye Care Services (TECS): A Novel Ophthalmologic Telemedicine Initiative
2017, OphthalmologyCitation Excerpt :There was a high correlation between the reading and face-to-face physician examination with the κ values and percent agreements consistent with those of other published studies.25–27 Multiple additional papers also validate the ability of diabetic teleretinal photographs to detect nondiabetic disease.25–29 Further studies may be warranted, however, because there are limitations to the TECS disease detection metric utilized in this report.
Northern Alberta remote teleglaucoma program: Clinical outcomes and patient disposition
2014, Canadian Journal of OphthalmologyInterobserver and Intraobserver Reliability of Detecting Age-related Macular Degeneration Using a Nonmydriatic Digital Camera
2008, American Journal of OphthalmologyEye Disease and the Older Diabetic
2008, Clinics in Geriatric MedicineCitation Excerpt :Given the poor outcomes for vision, neovascular glaucoma is a disease that should be monitored by a medical team that includes general practitioners, endocrinologists, neurologists, rheumatologists, and cardiologists [40]. Research on the development of strategies to increase the sensitivity of detecting the incidence of neovascular glaucoma is ongoing [41]. Although no causative effect has ever been found between age-related macular degeneration and DM, there nonetheless is an interaction.
- ⁎
Members of the Ocular TeleHealth Team who made significant contributions to this work: Anthony A. Cavallerano, O.D., Ocular TeleHealth Center, VA Boston Healthcare System–Jamaica Plain Campus, Jamaica Plain, Massachusetts; New England College of Optometry, Boston, Massachusetts. Gerald Selvin, O.D., Ocular TeleHealth Center, VA Boston Healthcare System–Jamaica Plain Campus, Jamaica Plain, Massachusetts; New England College of Optometry, Boston, Massachusetts. Kristin Colonna, B.S., New England College of Optometry, Boston, Massachusetts. Ghassan Ghorayeb, M.D., Boston University School of Medicine, Department of Ophthalmology, Boston, Massachusetts. Funding for the Diabetes Teleretinal program was provided in part from a contract sponsored by the Department of the Army by means of Cooperative Agreement DAMD 17-98-2-8017 for the Joslin/Department of Defense (DoD)/Veterans Administration (VA) Program. The views expressed in this article are those of the authors and do not necessarily reflect the position and policy of the United States Federal Government, the Department of Veterans Affairs or the Department of Defense. No official endorsement should be inferred.