Detection of idiopathic intracranial hypertension, enabled by tele-ophthalmology

Medert, Charles M.; Lynch, Mary G.; Maa, April Y.

doi:10.1016/j.jcjo.2016.11.009

Cited by 3 publications

(3 citation statements)

References 16 publications

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“…If easy access to ophthalmological care is not provided, many patients may not present to an ophthalmologist until IH has irreversibly altered their vision. As presented in a case report by Medert et al, the initial detection of idiopathic intracranial hypertension-associated papilledema in a male was made with the use of a comprehensive teleophthalmology screening examination, probably much earlier than it would have been if he had sought medical care in person [ 90 ]. An Italian study that scrutinized if smartphone-based ocular fundus photography could be used for the Emergency Department (ED) for hypertensive emergencies and compared it with traditional retinal fundoscopy, showed the decreased duration of examination and superior reliability of the smartphone-based method.…”

Section: Reviewmentioning

confidence: 99%

Teleophthalmology and Artificial Intelligence As Game Changers in Ophthalmic Care After the COVID-19 Pandemic

Nikolaidou¹,

Tsaousis

2021

Cureus

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The current COVID-19 pandemic has boosted a sudden demand for telemedicine due to quarantine and travel restrictions. The exponential increase in the use of telemedicine is expected to affect ophthalmology drastically. The aim of this review is to discuss the utility, effectiveness and challenges of teleophthalmological new tools for eyecare delivery as well as its implementation and possible facilitation with artificial intelligence. We used the terms: "teleophthalmology," "telemedicine and COVID-19," "retinal diseases and telemedicine," "virtual ophthalmology," "cost effectiveness of teleophthalmology," "pediatric teleophthalmology," "Artificial intelligence and ophthalmology," "Glaucoma and teleophthalmology" and "teleophthalmology limitations" in the database of PubMed and selected the articles being published in the course of 2015-2020. After the initial search, 321 articles returned as relevant. A meticulous screening followed and eventually 103 published manuscripts were included and used as our references. Emerging in the market, teleophthalmology is showing great potential for the future of ophthalmological care, benefiting both patients and ophthalmologists in times of pandemics. The spectrum of eye diseases that could benefit from teleophthalmology is wide, including mostly retinal diseases such as diabetic retinopathy, retinopathy of prematurity, age-related macular degeneration but also glaucoma and anterior segment conditions. Simultaneously, artificial intelligence provides ways of implementing teleophthalmology easier and with better outcomes, contributing as significant changing factors for ophthalmology practice after the COVID-19 pandemic.

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Section: Reviewmentioning

confidence: 99%

Teleophthalmology and Artificial Intelligence As Game Changers in Ophthalmic Care After the COVID-19 Pandemic

Nikolaidou¹,

Tsaousis

2021

Cureus

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“…21 More complex solutions have been arranged in neuro-ophthalmology, with 1 case report describing technologists in rural settings taking fundi photographs for a consulting ophthalmologist in an urban setting who was thereby able to diagnose idiopathic intracranial hypertension. 22 Temporomandibular disease management has also been performed successfully through e-consultation. 23 For headache medicine, in particular, e-consultation has been reported primarily by the European Headache Federation, which has developed an e-consultation system primarily aimed at obtaining second opinions.…”

Section: Introductionmentioning

confidence: 99%

“…Nationally or internationally renowned specialists often participate in e‐consultations, again through email 21 . More complex solutions have been arranged in neuro‐ophthalmology, with 1 case report describing technologists in rural settings taking fundi photographs for a consulting ophthalmologist in an urban setting who was thereby able to diagnose idiopathic intracranial hypertension 22 . Temporomandibular disease management has also been performed successfully through e‐consultation 23 .…”

Section: Introductionmentioning

confidence: 99%

E‐Consultation in Headache Medicine: A Quality Improvement Pilot Study

Robblee

Starling

2020

Headache

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Introduction Access to headache consultations by a headache specialist is limited. E‐consultations are an efficient approach shown to reduce costs and improve continuity of care with the primary care provider. Indications, suitability, and uptake in the headache population are not well studied. Methods This quality improvement pilot aims to explore the appropriateness of e‐consultations for patients referred to a headache specialist. E‐consultation feasibility was explored through (1) retrospective review of completed face‐to‐face consultations; (2) prospective survey of providers to identify face‐to‐face consultations appropriate for e‐consultation; (3) cross‐sectional review of the current waiting list to assess theoretical triaging to face‐to‐face vs e‐consultation; and (4) prospective review of all e‐consultations requested from an academic headache clinic to improve the understanding of e‐consultation feasibility and referral triage. Results The retrospective review included 75 face‐to‐face consultations with a mean (SD) wait time of 33 (39.4) days for consultations, of which 28/75 (37.3%) were deemed to be feasible e‐consultations. The prospective survey of providers identified 10 face‐to‐face consultations that were felt to be theoretically appropriate for e‐consultation. The cross‐sectional review identified 20 patients on the clinic waiting list, of whom 5/20 (25%) were theoretically triaged to e‐consultation. Finally, the prospective review found 12 requested e‐consultations, of which 6/12 (50%) were for migraine prophylaxis recommendations. Chart data often lacked details for complete assessments, with 5/12 (41.7%) converted to face‐to‐face consultations and only 4/12 (33.3%) deemed appropriate for e‐consultation. Conclusion E‐consultation in headache medicine could be considered if appropriately triaged. Pathways are needed to reach patients earlier in their disease course to ensure headache care meets guideline recommendations, and e‐consultation is 1 option. However, better communication with primary care is required for system optimization.

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Urgent Virtual Eye Assessments During the COVID-19 Pandemic

Ma¹,

Issa²,

Varma³

et al. 2022

OPTH

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Purpose We aimed to evaluate the effectiveness and safety of a virtual eye assessment triage system implemented in response to COVID-19. Patients and Methods We conducted a retrospective cross-sectional study using a consecutive sample of all virtual assessments conducted from March 24 to June 7, 2020 at a single ophthalmology center in Toronto, ON, Canada. Visual acuity and smartphone photographs were uploaded to an electronic assessment website. All patients were virtually triaged to an email or phone consult. Patient outcomes and satisfaction were assessed with a quality assurance survey. Primary outcome measures were the incidence of unplanned additional in-person visits and changes in treatment. Results We performed 1535 virtual assessments. Of the triage pathways, 15% received an email consult only and 85% received a phone consult. Subsequently, 15% required an in-person assessment, 3% were referred elsewhere, and 0.1% were sent to the emergency. Presentations were most commonly cornea (52%) and retina (25%). They were non-urgent in 68% of cases and no pharmacologic treatment was required for 49%. Of 397 patients that responded out of 653 patients surveyed, 4% had an unplanned additional visit to the emergency, after which two patients underwent urgent retinal surgery and one patient underwent urgent glaucoma surgery. Two patients (0.5%) had a minor change in treatment. Conclusion As routine regular in-person visits were not possible during the COVID-19 lockdown, virtual eye assessments provided an opportunity to triage patients. Virtual assessments have the potential to reduce in-person visits, but caution must be exercised to not miss vision-threatening conditions.

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Detection of idiopathic intracranial hypertension, enabled by tele-ophthalmology

Cited by 3 publications

References 16 publications

Teleophthalmology and Artificial Intelligence As Game Changers in Ophthalmic Care After the COVID-19 Pandemic

Teleophthalmology and Artificial Intelligence As Game Changers in Ophthalmic Care After the COVID-19 Pandemic

E‐Consultation in Headache Medicine: A Quality Improvement Pilot Study

Urgent Virtual Eye Assessments During the COVID-19 Pandemic

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