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A.D. Pennella, P. Schor, M.N. Burnier; Description and Test of a Digital Image System and a Virtual Enviromment to be Used in a Remote Second Referral Option in Ophthalmology . Invest. Ophthalmol. Vis. Sci. 2005;46(13):2756.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: To create and develop a program and a digital system to be used as a teleophthalmology instrument in a remote second referral program and to do objective tests to evaluate this system. Methods: Windows® based environment, Delphi® language, FTP and e–mail transfer capabilities and DBISAM database were used to develop the program. The program can capture images direct of the slit lamp using an analogical video camera attached in the slit lamp and connected to the Mattrox ® Metteor II capture board of the personal computer. This program offer the possibility to attach write files to the images of each patient. HTML pages, active forms, and a Linux server were used in the domain development named www.suportemedico.com.br. To test the whole system, forty–six cases of forty–six eyes examined in a traditional ophthalmologic clinic and the images and a few data were sent to the website using the program. Two virtual ophthalmologists did their syndromic and etiologic diagnosis based in the virtual files accessed in the website www.supoertemédico.com.br and the answers of the two virtual ophthalmologists were compared to the clinical files of each patient. Results: A program named Eyemail® was developed with the capabilities to receive clinical information and medical images, and to deliver them to a server by FTP and e–mail protocol. A website was created and named www.suportemédico.com.br, and received the informations from the program. The virtual consultant could access medical data in a password–protected environment. The images of the patient number 40 did not open and this patient was excluded of this study. Same syndromic diagnosis was achieved in 42 and 41 out of 45 eyes for consultant 1 and 2 respectively, leading to a statistical significant concordance of z1=1,53 and z2 = 1,83. Same etiologic diagnosis was achieved in 36 and 40 out of 45 eyes for consultant 1 and 2 respectively, leading to a not statistical significant concordance of z1=2,97 and z2 = 2,20. The expected "z" was z1 and z2>1,96. Conclusions: The results proved that the system has a potential use as a second referral program in syndromic diagnosis. It has limitations in the etiological diagnosis and must be used within this scope.
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