A Web-based Telemedicine System for Diabetic Retinopathy Screening Using Digital Fundus Photography

2006 ◽  
Vol 12 (1) ◽  
pp. 50-57 ◽  
Author(s):  
Jack C. Wei ◽  
Daniel J. Valentino ◽  
Douglas S. Bell ◽  
Richard S. Baker
Keyword(s):  
Diabetic Retinopathy ◽  
Fundus Photography ◽  
Telemedicine System ◽  
Web Based ◽  
Diabetic Retinopathy Screening ◽  
Retinopathy Screening

scholarly journals EyePACS: An Adaptable Telemedicine System for Diabetic Retinopathy Screening

2009 ◽  
Vol 3 (3) ◽  
pp. 509-516 ◽  
Author(s):  
Jorge Cuadros ◽  
George Bresnick
Keyword(s):  
Primary Care ◽  
Diabetic Retinopathy ◽  
Primary Care Providers ◽  
Retinal Images ◽  
Care Providers ◽  
Telemedicine System ◽  
Web Based ◽  
Diabetic Retinopathy Screening ◽  
Standard Clinical Practice ◽  
Retinopathy Screening

Background: Annual retinal screening of patients with diabetes is the standard clinical practice to prevent visual impairment and blindness from diabetic retinopathy. Telemedicine-based diabetic retinopathy screening (DRS) in primary care settings can effectively detect sight-threatening retinopathy and significantly increase compliance with annual retinal exams. EyePACS is a license-free Web-based DRS system designed to simplify the process of image capture, transmission, and review. The system provides a flexible platform for collaboration among clinicians about diabetic retinopathy. Methods: Primary clinic personnel (i.e., nursing, technical, or administrative staff) are trained and certified by the EyePACS program to acquire retinal images from standard digital retinal cameras. Relevant clinical data and eight high-resolution images per patient (two external and six retinal images) are encrypted and transmitted to a secure Internet server, using a standard computer and Web browser. Images are then interpreted by certified EyePACS reviewers or local eye care providers who are certified through the EyePACS Retinopathy Grading System. Reports indicating retinopathy level and referral recommendations are transmitted back to primary care providers through the EyePACS Web site or through interfaces between EyePACS and Health Level 7-compliant electronic medical records or chronic disease registries. Results: The pilot phase of the EyePACS DRS program in California (2005–2006) recorded 3562 encounters. Since 2006, EyePACS has been expanded to over 120 primary care sites throughout California and elsewhere recording over 34,000 DRSs. The overall rate of referral is 8.21% for sight-threatening retinopathy and 7.83% for other conditions (e.g., cataract and glaucoma). Conclusion: The use of license-free Web-based software, standard interfaces, and flexible protocols has allowed primary care providers to adopt retinopathy screening with minimal effort and resources.

Cost-Effectiveness Analysis of Non-Mydriatic Ultrawide- Field Fundus Photography versus Pharmacological Pupil Dilatation in Diabetic Retinopathy Screening Program

2021 ◽  
Vol 104 (5) ◽  
pp. 818-824
Keyword(s):  
Diabetic Retinopathy ◽  
Cost Effectiveness ◽  
Screening Program ◽  
Cost Effective ◽  
Cost Effectiveness Analysis ◽  
Fundus Photography ◽  
Diabetic Retinopathy Screening ◽  
Effectiveness Analysis ◽  
The Cost ◽  
Retinopathy Screening

Background: Diabetic retinopathy (DR) causes blindness of the population in many countries worldwide. Early detection and treatment of this disease via a DR screening program is the best way to secure the vision. An annual screening program using pharmacological pupil dilatation becomes the standard method. Recently, non-mydriatic ultrawide-field fundus photography (UWF) has been proposed as a choice for DR screening. However, there was no cost-effectiveness study between the standard DR screening and this UWF approach. Objective: To compare the cost-effectiveness between UWF and pharmacological pupil dilatation in terms of hospital and societal perspectives. Materials and Methods: Patients with type 2 diabetes mellitus that visited the ophthalmology clinic at Chulabhorn Hospital for DR screening were randomized using simple randomization method. The patients were interviewed by a trained interviewer for general and economic information. The clinical characteristics of DR and staging were recorded. Direct medical costs, direct non-medical costs, and informal care costs due to DR screening were recorded. Cost analyses were calculated for the hospital and societal perspectives. Results: The present study presented the cost-effectiveness analyses of UWF versus pharmacological pupil dilatation. Cost-effectiveness analysis from the hospital perspective showed the incremental cost-effectiveness ratio (ICER) of UWF to be –13.87. UWF was a cost-effective mean in DR screening in the societal perspective when compared with pharmacologically pupil dilatation with the ICER of 76.46, under the threshold of willingness to pay. Conclusion: The UWF was a cost-effective mean in DR screening. It can reduce screening duration and bypass post-screening blurred vision. The results suggested that UWF could be a viable option for DR screening. Keywords: Diabetic retinopathy, Diabetic retinopathy screening, Non-mydriatic ultrawide-field fundus photography, Cost-effectiveness analysis

Single-field fundus photography for diabetic retinopathy screening

Ophthalmology ◽  
2004 ◽  
Vol 111 (5) ◽  
pp. 1055-1062 ◽  
Author(s):  
George A Williams ◽  
Ingrid U Scott ◽  
Julia A Haller ◽  
Albert M Maguire ◽  
Dennis Marcus ◽  
...  
Keyword(s):  
Diabetic Retinopathy ◽  
Fundus Photography ◽  
Diabetic Retinopathy Screening ◽  
Single Field ◽  
Retinopathy Screening

scholarly journals EyeArt + EyePACS: Automated Retinal Image Analysis For Diabetic Retinopathy Screening in a Telemedicine System

2015 ◽  
Author(s):  
Malavika Bhaskaranand ◽  
Jorge Cuadros ◽  
Chaithanya Ramachandra ◽  
Sandeep Bhat ◽  
Muneeswar G. Nittala ◽  
...  
Keyword(s):  
Image Analysis ◽  
Diabetic Retinopathy ◽  
Retinal Image ◽  
Telemedicine System ◽  
Retinal Image Analysis ◽  
Diabetic Retinopathy Screening ◽  
Retinopathy Screening

The Role of Digital Fundus Photography in Diabetic Retinopathy Screening

1999 ◽  
Vol 1 (4) ◽  
pp. 477-487 ◽  
Author(s):  
Danny Y. Lin ◽  
Mark S. Blumenkranz ◽  
Rose Brothers ◽  
Digital Diabetic Screening Group
Keyword(s):  
Diabetic Retinopathy ◽  
Fundus Photography ◽  
Diabetic Retinopathy Screening ◽  
Retinopathy Screening

scholarly journals Imaging Modalities Employed in Diabetic Retinopathy Screening: A Review and Meta-Analysis

Diagnostics ◽  
2021 ◽  
Vol 11 (10) ◽  
pp. 1802
Author(s):  
Piotr Kanclerz ◽  
Raimo Tuuminen ◽  
Ramin Khoramnia
Keyword(s):  
Diabetic Retinopathy ◽  
Failure Rate ◽  
Meta Analysis ◽  
Imaging Modalities ◽  
Fundus Photography ◽  
Technical Failure ◽  
Diabetic Retinopathy Screening ◽  
Field Imaging ◽  
Ultrawide Field Imaging ◽  
Retinopathy Screening

Introduction: Urbanization has caused dramatic changes in lifestyle, and these rapid transitions have led to an increased risk of noncommunicable diseases, such as type 2 diabetes. In terms of cost-effectiveness, screening for diabetic retinopathy is a critical aspect in diabetes management. The aim of this study was to review the imaging modalities employed for retinal examination in diabetic retinopathy screening. Methods: The PubMed and Web of Science databases were the main sources used to investigate the medical literature. An extensive search was performed to identify relevant articles concerning “imaging”, “diabetic retinopathy” and “screening” up to 1 June 2021. Imaging techniques were divided into the following: (i) mydriatic fundus photography, (ii) non-mydriatic fundus photography, (iii) smartphone-based imaging, and (iv) ultrawide-field imaging. A meta-analysis was performed to analyze the performance and technical failure rate of each method. Results: The technical failure rates for mydriatic and non-mydriatic digital fundus photography, smartphone-based and ultrawide-field imaging were 3.4% (95% CI: 2.3–4.6%), 12.1% (95% CI: 5.4–18.7%), 5.3% (95% CI: 1.5–9.0%) and 2.2% (95% CI: 0.3–4.0%), respectively. The rate was significantly different between all analyzed techniques (p < 0.001), and the overall failure rate was 6.6% (4.9–8.3%; I2 = 97.2%). The publication bias factor for smartphone-based imaging was significantly higher than for mydriatic digital fundus photography and non-mydriatic digital fundus photography (b = −8.61, b = −2.59 and b = −7.03, respectively; p < 0.001). Ultrawide-field imaging studies were excluded from the final sensitivity/specificity analysis, as the total number of patients included was too small. Conclusions: Regardless of the type of the device used, retinal photographs should be taken on eyes with dilated pupils, unless contraindicated, as this setting decreases the rate of ungradable images. Smartphone-based and ultrawide-field imaging may become potential alternative methods for optimized DR screening; however, there is not yet enough evidence for these techniques to displace mydriatic fundus photography.

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