April 2011
Volume 52, Issue 14
ARVO Annual Meeting Abstract  |   April 2011
Optic Disc Imaging in Glaucoma Medicare Beneficiaries
Author Affiliations & Notes
  • Lakshmi Swamy
    Tri Institutional MD PhD program,
    Weill Cornell Medical College, New York, New York
  • Scott D. Smith
    Harkness Eye Institute, Columbia University, New York, New York
  • Nathan Radcliffe
    Weill Cornell Medical College, New York, New York
  • Footnotes
    Commercial Relationships  Lakshmi Swamy, None; Scott D. Smith, None; Nathan Radcliffe, None
  • Footnotes
    Support  Lakshmi Swamy is supported by National Institutes of Health Medical Scientist Training Program Grant GM07739.
Investigative Ophthalmology & Visual Science April 2011, Vol.52, 250. doi:
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      Lakshmi Swamy, Scott D. Smith, Nathan Radcliffe; Optic Disc Imaging in Glaucoma Medicare Beneficiaries. Invest. Ophthalmol. Vis. Sci. 2011;52(14):250.

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

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Purpose: : To assess the frequency with which ophthalmologists perform fundus photography and scanning computerized ophthalmic diagnostic imaging (SCODI) on patients receiving glaucoma care in the Medicare population.

Methods: : This study is a retrospective, observational, Medicare claims-based study. Data were obtained from a 5% random sample of Medicare beneficiaries from 2006 to 2008. The proportion of patients with an ICD-9 diagnosis of glaucoma or glaucoma suspect who received fundus photography (CPT 99250) or scanning computerized ophthalmic diagnostic imaging (SCODI; CPT 92135) was determined.

Results: : Nearly half (48%) of patients did not have any form of imaging during the study period. Among those who were imaged, 27% were imaged only once. The use of fundus photography was significantly lower than the use of SCODI (p < 0.00005). Seventy-five percent of those imaged once received SCODI while only 25% were photographed. These proportions were similar whether the analysis was restricted by diagnosis or by length of follow up. Among those imaged multiple times, the mean time between procedures was most frequently 13-16 months between photographs and 10-13 months between SCODI.

Conclusions: : Optic disc imaging in patients diagnosed with glaucoma or glaucoma suspect may not meet preferred practice guidelines set by the American Academy of Ophthalmology (AAO). Computerized imaging is performed more often and is repeated with greater frequency than fundus photography. Underutilization of imaging and of fundus photography in particular is of concern for the management of patients in which detection of glaucoma progression over time is crucial.

Keywords: imaging/image analysis: non-clinical • clinical (human) or epidemiologic studies: health care delivery/economics/manpower 

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