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Shachar Tauber, James Gessler, James T. Rogers, Mary Bourland, Crystal Trythall, Phillip Finley; Implementation Of An Ocular Telehealth Program Using Ultrawidefield Images To Increase Diabetic Eye Screening. Invest. Ophthalmol. Vis. Sci. 2012;53(14):2072.
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The purpose of this ongoing study is analyze the rate at which diabetic patients are being screened for retinopathy within primary care offices in southwest Missouri utilizing a novel approach to ocular telehealth and a single electronic medical record,
The Ocular Telehealth Program was implemented in four primary care physician (PCP) clinics at a integrated tertiary care health system in southwest Missouri. The program includes noninvasive nonmydriatic widefield optomap retinal images taken of diabetic patients’ eyes while in the PCP offices. These images are then evaluated by an integrated board certified ophthalmologist for pathology. The findings and any recommendations for future eye care were sent to the PCP via the electronic medical record
During the first three months of the program 340 images were obtained and evaluated. Out of these images, 55 patients showed evidence of eye pathology. The pathologies identified included diabetic retinopathy - 26 patients, AMD - 5 patients, BRAO or BRVO - 2 patients, asymmetrical cupping - 2 patients, hypertensive changes - 2 patients, cataract - 1 patient, solitary hemorrhage near disc - 1 patient, small nevus - 1 patient, RPE changes - 1 patient, Hollenhorst plaque - 1 patient, and other potential pathologies needing further evaluation - 13 patients. Out of the patients with diabetic retinopathy, 21 were diagnosed with mild, moderate, or severe non proliferative retinopathy and 5 showed signs of proliferative retinopathy with neo-vessels
The implementation, within the integrated PCP offices, of the Ocular Telehealth Program and a single electronic medical record has increased the rate at which diabetic patients are being screened for retinopathy. Early disease detection in these patients may have been otherwise missed without the evaluation of widefield retinal images. However, these results are preliminary; the study will continue long term to determine the impact of Ocular Telehealth Program on a larger cohort.
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