Lisa A Hark1, L Jay Katz2, Jonathan S Myers2, Michael Waisbourd3, Deiana Johnson3, Laura T Pizzi4, Benjamin E Leiby5, Scott J Fudemberg2, Anand V Mantravadi2, Jeffrey D Henderer6, Tingting Zhan5, Jeanne Molineaux3, Vance Doyle3, Meskerem Divers3, Christine Burns3, Ann P Murchison2, Shae Reber7, Arthur Resende3, Thien Dan V Bui8, Jane Lee9, John E Crews10, Jinan B Saaddine10, Paul P Lee11, Louis R Pasquale12, Julia A Haller13. 1. Glaucoma Research Center, Wills Eye Hospital, Philadelphia, Pennsylvania; Department of Ophthalmology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania; Department of Ophthalmology, Columbia University Medical Center, New York, NY. Electronic address: lhark@willseye.org. 2. Glaucoma Research Center, Wills Eye Hospital, Philadelphia, Pennsylvania; Department of Ophthalmology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania. 3. Glaucoma Research Center, Wills Eye Hospital, Philadelphia, Pennsylvania. 4. Center for Health Policy and Research, Rutgers University, New Brunswick, New Jersey. 5. Department of Pharmacology and Experimental Therapeutics, Division of Biostatistics, Thomas Jefferson University, Philadelphia, Pennsylvania. 6. Department of Ophthalmology, Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania. 7. Department of Telemedicine, Wills Eye Hospital, Philadelphia, Pennsylvania. 8. Department of Ophthalmology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania. 9. Drexel University College of Medicine, Philadelphia, Pennsylvania. 10. Division of Vision Health, Centers for Disease Control and Prevention, Atlanta, Georgia. 11. Department of Ophthalmology and Visual Sciences, W.K. Kellogg Eye Center, University of Michigan, Ann Arbor, Michigan. 12. Massachusetts Eye and Ear Infirmary, Boston, Massachusetts; Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, Massachusetts. 13. Ophthalmologist-in-Chief, Wills Eye Hospital, Philadelphia, Pennsylvania; Department of Ophthalmology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania.
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.
RCT Entities:
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.
Authors: Tapan P Patel; N Venkatesh Prajna; Sina Farsiu; Nita G Valikodath; Leslie M Niziol; Lakshey Dudeja; Kyeong Hwan Kim; Maria A Woodward Journal: Cornea Date: 2018-03 Impact factor: 2.651
Authors: Benjamin E Leiby; Sarah E Hegarty; Tingting Zhan; Jonathan S Myers; L Jay Katz; Julia A Haller; Michael Waisbourd; Christine Burns; Meskerem Divers; Jeanne Molineaux; Jeffrey Henderer; Charles Brodowski; Lisa A Hark Journal: Prev Chronic Dis Date: 2021-05-20 Impact factor: 2.830
Authors: Paula A Newman-Casey; David C Musch; Leslie M Niziol; Angela R Elam; Jason Zhang; Sayoko E Moroi; Leroy Johnson; Martha Kershaw; Jinan Saadine; Suzanne Winter; Maria A Woodward Journal: J Glaucoma Date: 2021-05-01 Impact factor: 2.290
Authors: Shuai-Chun Lin; Cindy X Zheng; Michael Waisbourd; Jeanne Molineaux; Lichuan Zeng; Tingting Zhan; Kamran Rahmatnejad; Arthur Resende; Anand V Mantravadi; Lisa A Hark; Marlene R Moster; Joseph I Markoff; George L Spaeth; L Jay Katz Journal: J Ophthalmic Vis Res Date: 2018 Jul-Sep