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C.H. Parikh, S. Fowler, R. Davis; Cataract Screening Using Telemedicine and Digital Fundus Photography . Invest. Ophthalmol. Vis. Sci. 2005;46(13):1944.
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Purpose: A digital fundus camera with image transfer capacity can be used to screen patients, who reside in rural communities without access to eye care providers, for diabetic retinopathy. Additionally, digital images of the lens may be acquired and transferred to a remote reading center. We have retrospectively evaluated the charts of patients who were screened for retinopathy and lens status. In this study, we report on the feasibility of lens assessment utilizing the fundus camera. Methods: We used a Topcon Nonmydriatic Fundus Camera to take real–time images of the posterior fundus. Additionally, our technician at the rural health center assessed visual acuity (Va) and measured intraocular pressure (IOP). Evaluation of the lens was accomplished by advancing the retinal camera for adequate imaging of the lens. Results: Of our series of 73 patients (146 eyes), 32 eyes were noted to have cataracts. The median visual acuity was 20/25 (n=23). Of these 32 eyes, 12 had nonproliferative diabetic retinopathy (NPDR), proliferative diabetic retinopathy (PDR), or exudative maculopathy. 111 eyes either had no reported cataracts or had no lens assessment documented. The median visual acuity of these eyes was 20/25 (n=86). Of the 111 eyes, 31 were noted to have diabetic retinopathy, either NPDR, PDR, exudative maculopathy or clinically significant diabetic macular edema. Finally, 2 eyes were pseudophakic, and another had traumatic damage. Conclusions: In this feasibility study, we have evaluated the possibility of using telemedicine and a digital fundus camera to detect cataracts. We believe that screening for retinopathy and cataracts with telemedicine capacity may represent an efficient means to address health access problems in rural communities. Since cataracts are the leading cause of treatable blindness worldwide, any technique that allows these patients earlier access to the health care system is advantageous.
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