Feasibility of Telemedicine in Detecting Diabetic Retinopathy and Age-Related Macular Degeneration

Abstract Age-related macular degeneration and diabetic retinopathy are important causes of visual impairment and blindness in the world. Because of recent advances and newly available treatment modalities along with the devastating consequences associated with late stages of these diseases, much attention has been paid to the importance of early detection and improving patient access to specialist care. Telemedicine or, more specifically, digital retinal imaging utilizing telemedical technology has been proposed as an important alternative screening and management strategy to help meet this demand. In this paper, we perform a literature review and analysis that evaluates the validity and feasibility of telemedicine in detecting diabetic retinopathy and age-related macular degeneration. Understanding both the progress and barriers to progress that have been demonstrated in these two areas is important for future telemedicine research projects and innovations in telemedicine technology.

[1]  K. Angioi,et al.  Mass community screening for diabetic retinopathy using a nonmydriatic camera with telemedicine. , 2005, Canadian journal of ophthalmology. Journal canadien d'ophtalmologie.

[2]  R. Klein,et al.  Prevalence of age-related macular degeneration in the US population. , 2011, Archives of ophthalmology.

[3]  Andrew Ting,et al.  Web-based grading of compressed stereoscopic digital photography versus standard slide film photography for the diagnosis of diabetic retinopathy. , 2007, Ophthalmology.

[4]  Lloyd Paul Aiello,et al.  Nonmydriatic ultrawide field retinal imaging compared with dilated standard 7-field 35-mm photography and retinal specialist examination for evaluation of diabetic retinopathy. , 2012, American journal of ophthalmology.

[5]  Usha Chakravarthy,et al.  Prevalence of age-related maculopathy in older Europeans: the European Eye Study (EUREYE). , 2006, Archives of ophthalmology.

[6]  F. Gómez-Ulla,et al.  A comparative cost analysis of digital fundus imaging and direct fundus examination for assessment of diabetic retinopathy. , 2008, Telemedicine journal and e-health : the official journal of the American Telemedicine Association.

[7]  Mark B Horton,et al.  A modeled economic analysis of a digital tele-ophthalmology system as used by three federal health care agencies for detecting proliferative diabetic retinopathy. , 2005, Telemedicine journal and e-health : the official journal of the American Telemedicine Association.

[8]  Cathy R. Taylor,et al.  Improving Diabetic Retinopathy Screening Ratios Using Telemedicine-Based Digital Retinal Imaging Technology , 2007, Diabetes Care.

[9]  P. Sharp,et al.  Fundus imaging in patients with cataract: role for a variable wavelength scanning laser ophthalmoscope. , 1995, The British journal of ophthalmology.

[10]  M. Blumenkranz,et al.  The sensitivity and specificity of single-field nonmydriatic monochromatic digital fundus photography with remote image interpretation for diabetic retinopathy screening: a comparison with ophthalmoscopy and standardized mydriatic color photography. , 2002, American journal of ophthalmology.

[11]  R. Klein,et al.  The cost-effectiveness of three screening alternatives for people with diabetes with no or early diabetic retinopathy. , 2011, Health services research.

[12]  P. L. Hildebrand,et al.  Clinical evaluation of patients with diabetic retinopathy: accuracy of the Inoveon diabetic retinopathy-3DT system. , 2002, Ophthalmology.

[13]  M. Abràmoff,et al.  Web-based screening for diabetic retinopathy in a primary care population: the EyeCheck project. , 2005, Telemedicine journal and e-health : the official journal of the American Telemedicine Association.

[14]  A. Darkins,et al.  Framework for a national teleretinal imaging program to screen for diabetic retinopathy in Veterans Health Administration patients. , 2006, Journal of rehabilitation research and development.

[15]  Pedro Romero-Aroca,et al.  Prospective comparison of two methods of screening for diabetic retinopathy by nonmydriatic fundus camera , 2010, Clinical ophthalmology.

[16]  A. Avogaro,et al.  Screening for diabetic retinopathy: 1 and 3 nonmydriatic 45-degree digital fundus photographs vs 7 standard early treatment diabetic retinopathy study fields. , 2009, American journal of ophthalmology.

[17]  Jennifer I. Lim,et al.  A randomized, placebo-controlled, clinical trial of high-dose supplementation with vitamins C and E, beta carotene, and zinc for age-related macular degeneration and vision loss: AREDS report no. 8. , 2001, Archives of ophthalmology.

[18]  R. Holman,et al.  Tight blood pressure control and risk of macrovascular and microvascular complications in type 2 diabetes: UKPDS 38. UK Prospective Diabetes Study Group. , 1998 .

[19]  Helen K. Li,et al.  Telehealth practice recommendations for diabetic retinopathy, second edition. , 2011, Telemedicine journal and e-health : the official journal of the American Telemedicine Association.

[20]  M. C. Leske,et al.  Patterns of adherence to diabetes vision care guidelines: baseline findings from the Diabetic Retinopathy Awareness Program. , 2001, Ophthalmology.

[21]  R. Raman,et al.  Patient satisfaction levels during teleophthalmology consultation in rural South India. , 2006, Telemedicine journal and e-health : the official journal of the American Telemedicine Association.

[22]  R. Klein,et al.  Prevalence of age-related maculopathy. The Beaver Dam Eye Study. , 1992, Ophthalmology.

[23]  S. Kelly,et al.  Teleophthalmology with optical coherence tomography imaging in community optometry. Evaluation of a quality improvement for macular patients , 2011, Clinical ophthalmology.

[24]  Helen K. Li,et al.  Cost-Effectiveness Analysis of Telemedicine to Evaluate Diabetic Retinopathy in a Prison Population , 2004 .

[25]  Diane M Gibson,et al.  Diabetic retinopathy and age-related macular degeneration in the U.S. , 2012, American journal of preventive medicine.

[26]  Matthew D. Davis,et al.  Comparison of digital and film grading of diabetic retinopathy severity in the diabetes control and complications trial/epidemiology of diabetes interventions and complications study. , 2011, Archives of ophthalmology.

[27]  Usha Chakravarthy,et al.  Grading of age-related maculopathy for epidemiological studies: is digital imaging as good as 35-mm film? , 2003, Ophthalmology.

[28]  R. Spaide,et al.  INTRAVITREAL BEVACIZUMAB (AVASTIN) TREATMENT OF PROLIFERATIVE DIABETIC RETINOPATHY COMPLICATED BY VITREOUS HEMORRHAGE , 2006, Retina.

[29]  Jennifer I. Lim,et al.  COMPARISON OF NONMYDRIATIC DIGITIZED VIDEO FUNDUS IMAGES WITH STANDARD 35-MM SLIDES TO SCREEN FOR AND IDENTIFY SPECIFIC LESIONS OF AGE-RELATED MACULAR DEGENERATION , 2002, Retina.

[30]  David Maberley,et al.  Screening for diabetic retinopathy in James Bay, Ontario: a cost-effectiveness analysis. , 2003, CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne.

[31]  S. Ito,et al.  Use of telemedicine in periodic screening of diabetic retinopathy. , 2003, Telemedicine journal and e-health.

[32]  H. O. Neto,et al.  Intravitreal Bevacizumab (Avastin) in the Treatment of Proliferative Diabetic Retinopathy , 2007 .

[33]  Francis L. McVeigh,et al.  Telehealth practice recommendations for diabetic retinopathy. , 2004, Telemedicine journal and e-health : the official journal of the American Telemedicine Association.

[34]  A D Négrel,et al.  2002 Global update of available data on visual impairment: a compilation of population-based prevalence studies , 2004, Ophthalmic epidemiology.

[35]  Ann L. Albright,et al.  Prevalence of diabetic retinopathy in the United States, 2005-2008. , 2010, JAMA.

[36]  R. Zeimer,et al.  A fundus camera dedicated to the screening of diabetic retinopathy in the primary-care physician's office. , 2002, Investigative ophthalmology & visual science.

[37]  Grading diabetic retinopathy from stereoscopic color fundus photographs--an extension of the modified Airlie House classification. ETDRS report number 10. Early Treatment Diabetic Retinopathy Study Research Group. , 1991, Ophthalmology.

[38]  A. Cruess,et al.  Factors Associated with Missed Eye Examinations in a Cohort with Diabetes , 2002, Canadian journal of public health = Revue canadienne de sante publique.

[39]  Justin Starren,et al.  Telemedicine for retinopathy of prematurity diagnosis: evaluation and challenges. , 2009, Survey of ophthalmology.

[40]  Early vitrectomy for severe vitreous hemorrhage in diabetic retinopathy. Two-year results of a randomized trial. Diabetic Retinopathy Vitrectomy Study report 2. The Diabetic Retinopathy Vitrectomy Study Research Group. , 1985, Archives of ophthalmology.

[41]  Johanna M Seddon,et al.  Age-related macular degeneration , 2012, The Lancet.

[42]  Ronald Klein,et al.  Screening for diabetic retinopathy, revisited. , 2002, American journal of ophthalmology.

[43]  L. Aiello,et al.  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. , 2001, Ophthalmology.

[44]  J. R. Landis,et al.  The measurement of observer agreement for categorical data. , 1977, Biometrics.

[45]  R. Klein,et al.  Causes and prevalence of visual impairment among adults in the United States. , 2004, Archives of ophthalmology.

[46]  P. Jong.  Prevalence of age-related macular degeneration in the United States. , 2004 .

[47]  A Randomized, Placebo-Controlled, Clinical Trial of High-Dose Supplementation With Vitamins C and E, Beta Carotene, and Zinc for Age-Related Macular Degeneration and Vision Loss , 2001 .

[48]  David S. Shin,et al.  GRADING, IMAGE ANALYSIS, AND STEREOPSIS OF DIGITALLY COMPRESSED FUNDUS IMAGES , 2000, Retina.

[49]  Benita J. O’Colmain,et al.  Prevalence of age-related macular degeneration in the United States. , 2004, Archives of ophthalmology.

[50]  L. Pizzarello.  The dimensions of the problem of eye disease among the elderly. , 1987, Ophthalmology.

[51]  Fundus photographic risk factors for progression of diabetic retinopathy. ETDRS report number 12. Early Treatment Diabetic Retinopathy Study Research Group. , 1991, Ophthalmology.

[52]  Peter J. Kertes.  SINGLE-FIELD FUNDUS PHOTOGRAPHY FOR DIABETIC RETINOPATHY SCREENING: A REPORT BY THE AMERICAN ACADEMY OF OPHTHALMOLOGY , 2004 .

[53]  I. Zimmer-Galler,et al.  Feasibility of screening for high-risk age-related macular degeneration with an Internet-based automated fundus camera. , 2005, Ophthalmic surgery, lasers & imaging : the official journal of the International Society for Imaging in the Eye.

[54]  Comparison of a digital retinal imaging system and seven-field stereo color fundus photography to detect diabetic retinopathy in the primary care environment. , 2005, Ophthalmic surgery, lasers & imaging : the official journal of the International Society for Imaging in the Eye.

[55]  A. Erginay,et al.  Evaluation of a screening program for diabetic retinopathy in a primary care setting Dodia (Dépistage ophtalmologique du diabète) study. , 2005, Diabetes & metabolism.

[56]  E. Souied,et al.  Interobserver and intraobserver reliability of detecting age-related macular degeneration using a nonmydriatic digital camera. , 2008, American journal of ophthalmology.

[57]  Ronald Klein,et al.  Fifteen-year cumulative incidence of age-related macular degeneration: the Beaver Dam Eye Study. , 2007, Ophthalmology.

[58]  B. Klein,et al.  Overview of epidemiologic studies of diabetic retinopathy. , 2007, Ophthalmic epidemiology.

[59]  H. Flynn,et al.  Vitrectomy in the management of diabetic eye disease. , 1992, Survey of ophthalmology.

[60]  G. Duvel.  The study group. , 1980 .

[61]  T. Sheidow,et al.  Prospective evaluation of digital non-stereo color fundus photography as a screening tool in age-related macular degeneration. , 2005, American journal of ophthalmology.

[62]  S. Jain,et al.  Screening for age-related macular degeneration using nonstereo digital fundus photographs , 2006, Eye.

[63]  Q. Wang,et al.  Barriers to compliance with screening guidelines for diabetic retinopathy. , 1999, Ophthalmic epidemiology.

[64]  A. Kampik,et al.  Assessment of Diabetic Retinopathy Using Nonmydriatic Ultra-Widefield Scanning Laser Ophthalmoscopy (Optomap) Compared With ETDRS 7-Field Stereo Photography , 2012, Diabetes Care.

[65]  K. Desalvo,et al.  Perceived barriers to diabetic eye care: qualitative study of patients and physicians. , 2005, Archives of ophthalmology.

[66]  Helen K. Li,et al.  MOSAICS VERSUS EARLY TREATMENT DIABETIC RETINOPATHY SEVEN STANDARD FIELDS FOR EVALUATION OF DIABETIC RETINOPATHY SEVERITY , 2011, Retina.

[67]  M. C. Leske,et al.  The prevalence of diabetic retinopathy among adults in the United States. , 2004, Archives of ophthalmology.

[68]  D. Pauleikhoff,et al.  Prevalence of age‐related macular degeneration , 1995, Current opinion in ophthalmology.