Purchase this article with an account.
I. E. Zimmer-Galler, J. Handa, M. Wieland, V. Yano, K. Quinn, R. Zeimer; Use of Telemedicine to Improve Access to Eye Care in a Remote Underserved Area. Invest. Ophthalmol. Vis. Sci. 2009;50(13):2500.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
The Pacific island nation of Palau has a population of approximately 20,000. As a more western life-style is being adopted, the incidence of diabetes is rising at an alarming rate. Health care services are limited and there are no retina specialists in Palau to diagnose and treat the complications of diabetic retinopathy. The purpose of this study is to evaluate the implementation of a telemedicine diabetic retinopathy assessment sytem with remote image interpretation to assist in eye care delivery on this island nation.
Two retina specialists (JH, MW) travel from the United States to Palau for several weeks each year to provide humanitarian eye care including laser and surgical treatment of retinal diseases. A telemedicine program has been implemented to assess patients remotely to identify those patients who will most benefit from intervention by the visiting retina specialists. The program utilizes an easy to operate automated fundus camera to image patients with diabetes. Images are obtained throughout the year by local health care providers. The images are reviewed at a reading center in the United States to identify patients requiring treatment. This allows optimal triage of patients in order that efforts can be focused on patients who will most benefit from intervention when the retina specialists return annually to Palau for several weeks.
The retinal camera was implemented in Palau in January 2007 and is being used to image patients with diabetes. To date, 74 patients have been imaged. Seventeen eyes of 9 patients were identified as requiring intervention (12 with diabetic macular edema, 3 with severe nonproliferative diabetic retinopathy or proliferative diabetic retinopathy, 1 with full thickness macular hole, 1 with branch retinal vein ccclusion). An additional 26 patients were noted to have mild to moderate nonproliferative diabetic retinopathy and will be re-imaged in one year. Images were unreadable for 16 patients. Twenty three patients had normal images with no abnormality noted in either eye.
A telemedicine program has been successfully implemented on the isolated island nation of Palau. Patients requiring specialist care can be identified remotely to maximize the limited time of retinal specialists during their brief annual visit to Palau to provide eye care.
This PDF is available to Subscribers Only