April 2014
Volume 55, Issue 13
Free
ARVO Annual Meeting Abstract  |   April 2014
Prospective evaluation of Tele-Ophthalmology in initial screening and recurrence monitoring for wet Age-related Macular Degeneration (AMD)
Author Affiliations & Notes
  • Bo Li
    Ivey Eye Institute, Western University, London, ON, Canada
  • Anne Marie Powell
    Ivey Eye Institute, Western University, London, ON, Canada
  • Phil Hooper
    Ivey Eye Institute, Western University, London, ON, Canada
  • Thomas G Sheidow
    Ivey Eye Institute, Western University, London, ON, Canada
  • Footnotes
    Commercial Relationships Bo Li, None; Anne Marie Powell, None; Phil Hooper, None; Thomas Sheidow, None
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science April 2014, Vol.55, 4941. doi:
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      Bo Li, Anne Marie Powell, Phil Hooper, Thomas G Sheidow; Prospective evaluation of Tele-Ophthalmology in initial screening and recurrence monitoring for wet Age-related Macular Degeneration (AMD). Invest. Ophthalmol. Vis. Sci. 2014;55(13):4941.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose: To evaluate Tele-Ophthalmology as a tool for screening and monitoring recurrence for wet AMD

Methods: Group S: 106 new referral eyes for suspected wet AMD were randomized into routine (IEI-S) or tele-ophthalmology (OHC-S) screening group over a one year period. In the IEI-S group, diagnostic imaging and in-person assessment were performed by retinal consultants at the Ivey Eye Institute (IEI). In the OHC-S group, diagnostic imaging and routine examination were performed at the Ocular Health Centre. OHC-S patients were given evaluation at the IEI if the tele-ophthalmology data from the OHC suggested possible wet AMD. Waiting time between referral, imaging and treatment were calculated. Group M: 63 eyes previously treated for wet AMD at the IEI and without evidence of disease activity were randomized into routine (IEI-M) or tele-ophthalmology monitoring (OHC-M) group. The IEI-M group received regular follow-ups with a retinal consultant with diagnostic imaging at the IEI. The OHC-M group received regular diagnostic imaging and routine examinations at the OHC. OHC-M patients were recalled back to the IEI for treatment if the teleophthalmology data suggested recurrent disease activity. Time for recurrence, treatment initiation and visual acuity were recorded.

Results: The average referral to diagnostic imaging time was 22.5 days for OHC-S and 18.0 days for IEI-S group (P=0.23). The average diagnostic imaging to treatment time was 16.4 days for OHC-S and 11.6 days for the IEI-S group (P=0.11). The overall referral to treatment time was 39.1 days for the OHC-S and 30.4 days for the IEI-S group (P=0.19). The average time for recurrence for the IEI-M was 108.1 days and 103.9 days for the OHC-M group (P=0.85). The average recurrence to treatment time was statistical shorter for the IEI-M group at 0.04 day, compared with 13.6 days for the OHC-M group (P<0.01). The average end-of-study visual acuity was 20/186 for the IEI-M and 20/185 for the OHC-M group (P=0.99).

Conclusions: Tele-Ophthalmology screening for suspected wet AMD does not result in delay of referral to treatment time when compared with retinal consultant based screening. Even though tele-ophthalmology monitoring for wet AMD recurrence resulted in longer wait time for treatment re-initiation, this difference does not result in worse visual outcome.

Keywords: 412 age-related macular degeneration • 688 retina  
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