Philadelphia Telemedicine Glaucoma Detection and Follow-up Study: Methods and Screening Results

Lisa A. Hark, L. Jay Katz, Jonathan S. Myers, Michael Waisbourd, Deiana Johnson, Laura T. Pizzi, Benjamin E. Leiby, Scott J. Fudemberg, Anand V. Mantravadi, Jeffrey D. Henderer, Tingting Zhan, Jeanne Molineaux, Vance Doyle, Meskerem Divers, Christine Burns, Ann P. Murchison, Shae Reber, Arthur Resende, Thien Dan V. Bui, Jane LeeJohn E. Crews, Jinan B. Saaddine, Paul P. Lee, Louis R. Pasquale, Julia A. Haller

Research output: Contribution to journalArticlepeer-review

62 Scopus citations

Abstract

Purpose To describe methodology and screening results from the Philadelphia Telemedicine Glaucoma Detection and Follow-up Study. Design Screening program results for a prospective randomized clinical trial. Methods Individuals were recruited who were African-American, Hispanic/Latino, or Asian over age 40 years; white individuals over age 65 years; and any ethnicity over age 40 years with a family history of glaucoma or diabetes. Primary care offices and Federally Qualified Health Centers were used for telemedicine (Visit 1). Two posterior fundus photographs and 1 anterior segment photograph were captured per eye in each participant, using a nonmydriatic, autofocus, hand-held fundus camera (Volk Optical, Mentor, Ohio, USA). Medical and ocular history, family history of glaucoma, visual acuity, and intraocular pressure measurements using the ICare rebound tonometer (ICare, Helsinki, Finland) were obtained. Images were read remotely by a trained retina reader and a glaucoma specialist. Results From April 1, 2015, to February 6, 2017, 906 individuals consented and attended Visit 1. Of these, 553 participants were female (61.0%) and 550 were African-American (60.7%), with a mean age of 58.7 years. A total of 532 (58.7%) participants had diabetes, and 616 (68%) had a history of hypertension. During Visit 1, 356 (39.3%) participants were graded with a normal image. Using image data from the worse eye, 333 (36.8%) were abnormal and 155 (17.1%) were unreadable. A total of 258 (28.5%) had a suspicious nerve, 62 (6.8%) had ocular hypertension, 102 (11.3%) had diabetic retinopathy, and 68 (7.5%) had other retinal abnormalities. Conclusion An integrated telemedicine screening intervention in primary care offices and Federally Qualified Health Centers detected high rate of suspicious optic nerves, ocular hypertension, and retinal pathology.

Original languageEnglish
Pages (from-to)114-124
Number of pages11
JournalAmerican Journal of Ophthalmology
Volume181
DOIs
StatePublished - Sep 2017
Externally publishedYes

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