Identification of Diabetic Retinopathy and Ungradable Image Rate with Ultrawide Field Imaging in a National Teleophthalmology Program

Silva, Paolo S.; Horton, Mark B.; Clary, Dawn; Lewis, Drew G.; Sun, Jennifer K.; Cavallerano, Jerry D.; Aiello, Lloyd Paul

doi:10.1016/j.ophtha.2016.01.043

Cited by 120 publications

(85 citation statements)

References 11 publications

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“…Moreover, by using ultrawide-field imaging, peripheral lesions were identified in 10% of subjects that were suggestive of more severe diabetic retinopathy. 20 …”

Section: Hospital-based Evaluationsmentioning

confidence: 99%

The Current State of Teleophthalmology in the United States

et al. 2017

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Telemedicine services facilitate the evaluation, diagnosis, and management of the remote patient. Telemedicine has rapidly flourished in the United States and has improved access to care, outcomes, and patient satisfaction. However, the use of telemedicine in ophthalmology is currently in its infancy and has yet to gain wide acceptance. Current models of telemedicine in ophthalmology are largely performed via “store and forward” methods, but remote monitoring and interactive modalities exist. Although studies have examined the effects of telemedicine, few reports have characterized its current status. We perform a descriptive analysis of the current state of teleophthalmology in the United States. We describe the use of teleophthalmology in the hospital and outpatient settings. We also review the applications to retinopathy of prematurity, diabetic retinopathy, age-related macular degeneration, and glaucoma, as well as anticipated barriers and hurdles for the future adoption of teleophthalmology. With ongoing advances in teleophthalmology, these models may provide earlier detection and more reliable monitoring of vision-threatening diseases.

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“…Moreover, by using ultrawide-field imaging, peripheral lesions were identified in 10% of subjects that were suggestive of more severe diabetic retinopathy. 20 …”

Section: Hospital-based Evaluationsmentioning

confidence: 99%

The Current State of Teleophthalmology in the United States

et al. 2017

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“…In one national ocular telehealth program focused on DR, nonmydriatic UWF imaging reduced the ungradable image rate by 81%, nearly doubled the identification of DR, and identified peripheral lesions suggestive of more severe disease in nearly 10% of patients, compared to nonmydriatic multifield fundus photography. 12 We have consistently seen similar benefits in our practice and have carefully evaluated the impact of UWF retinal imaging on the quality, costeffectiveness and revenue potential of the care we deliver, as well as its contribution to patient satisfaction.…”

Section: Elements Of Efficiency For Diagnostic Imagingmentioning

confidence: 77%

The Impact of Ultra-widefield Retinal Imaging on Practice Efficiency

Tornambe¹

2017

US Ophthalmic Review

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In the current cost-and resource-constrained healthcare environment in the United States, characterized by declining government reimbursement and increased utilization scrutiny by managed care plans, providers are challenged to continue delivering quality care to more patients while also more effectively managing practice economics. Employing technology to improve practice efficiency is one of the most promising solutions to this dilemma. We have demonstrated that the integration of ultra-widefield (UWF) retinal imaging in our practice is cost-effective. It has allowed us to increase the number of patient encounters while simultaneously raising the quality of care, and increasing patient satisfaction.

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“…[28] The Joslin Vision Network introduced non-mydriatic ultra-widefield retinal imaging in October 2014, and compared the use of this imaging system against the established non-mydriatic fundus photography system with the optical Topcon TRC-NW6S non-mydriatic retinal camera. [29] The group reported an 81% reduction of ungradable eyes, 2-fold increased identification of diabetic retinopathy, and an additional 10% of patients with peripheral lesions that suggested more severe diabetic retinopathy. [29] These findings provide evidence supporting the use of non-mydriatic ultra-widefield retinal imaging systems in a diabetic retinopathy telemedicine system.…”

Section: Diabetic Retinopathy and Other Adult Retinal Diseasesmentioning

confidence: 99%

“…[29] The group reported an 81% reduction of ungradable eyes, 2-fold increased identification of diabetic retinopathy, and an additional 10% of patients with peripheral lesions that suggested more severe diabetic retinopathy. [29] These findings provide evidence supporting the use of non-mydriatic ultra-widefield retinal imaging systems in a diabetic retinopathy telemedicine system.…”

Section: Diabetic Retinopathy and Other Adult Retinal Diseasesmentioning

confidence: 99%