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 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 journalArticle

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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 (US)
Pages (from-to)114-124
Number of pages11
JournalAmerican journal of ophthalmology
Volume181
DOIs
StatePublished - Sep 1 2017

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Telemedicine
Glaucoma
Ocular Hypertension
Hispanic Americans
African Americans
Primary Health Care
Medical History Taking
Mentors
Health
Diabetic Retinopathy
Finland
Optic Nerve
Intraocular Pressure
Visual Acuity
Retina
Randomized Controlled Trials
Hand
Pathology
Hypertension

All Science Journal Classification (ASJC) codes

  • Ophthalmology

Cite this

Hark, Lisa A. ; Katz, L. Jay ; Myers, Jonathan S. ; Waisbourd, Michael ; Johnson, Deiana ; Pizzi, Laura ; Leiby, Benjamin E. ; Fudemberg, Scott J. ; Mantravadi, Anand V. ; Henderer, Jeffrey D. ; Zhan, Tingting ; Molineaux, Jeanne ; Doyle, Vance ; Divers, Meskerem ; Burns, Christine ; Murchison, Ann P. ; Reber, Shae ; Resende, Arthur ; Bui, Thien Dan V. ; Lee, Jane ; Crews, John E. ; Saaddine, Jinan B. ; Lee, Paul P. ; Pasquale, Louis R. ; Haller, Julia A. / Philadelphia Telemedicine Glaucoma Detection and Follow-up Study : Methods and Screening Results. In: American journal of ophthalmology. 2017 ; Vol. 181. pp. 114-124.
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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.",
author = "Hark, {Lisa A.} and Katz, {L. Jay} and Myers, {Jonathan S.} and Michael Waisbourd and Deiana Johnson and Laura Pizzi and Leiby, {Benjamin E.} and Fudemberg, {Scott J.} and Mantravadi, {Anand V.} and Henderer, {Jeffrey D.} and Tingting Zhan and Jeanne Molineaux and Vance Doyle and Meskerem Divers and Christine Burns and Murchison, {Ann P.} and Shae Reber and Arthur Resende and Bui, {Thien Dan V.} and Jane Lee and Crews, {John E.} and Saaddine, {Jinan B.} and Lee, {Paul P.} and Pasquale, {Louis R.} and Haller, {Julia A.}",
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Hark, LA, Katz, LJ, Myers, JS, Waisbourd, M, Johnson, D, Pizzi, L, Leiby, BE, Fudemberg, SJ, Mantravadi, AV, Henderer, JD, Zhan, T, Molineaux, J, Doyle, V, Divers, M, Burns, C, Murchison, AP, Reber, S, Resende, A, Bui, TDV, Lee, J, Crews, JE, Saaddine, JB, Lee, PP, Pasquale, LR & Haller, JA 2017, 'Philadelphia Telemedicine Glaucoma Detection and Follow-up Study: Methods and Screening Results', American journal of ophthalmology, vol. 181, pp. 114-124. https://doi.org/10.1016/j.ajo.2017.06.024

Philadelphia Telemedicine Glaucoma Detection and Follow-up Study : Methods and Screening Results. / Hark, Lisa A.; Katz, L. Jay; Myers, Jonathan S.; Waisbourd, Michael; Johnson, Deiana; Pizzi, Laura; Leiby, Benjamin E.; Fudemberg, Scott J.; Mantravadi, Anand V.; Henderer, Jeffrey D.; Zhan, Tingting; Molineaux, Jeanne; Doyle, Vance; Divers, Meskerem; Burns, Christine; Murchison, Ann P.; Reber, Shae; Resende, Arthur; Bui, Thien Dan V.; Lee, Jane; Crews, John E.; Saaddine, Jinan B.; Lee, Paul P.; Pasquale, Louis R.; Haller, Julia A.

In: American journal of ophthalmology, Vol. 181, 01.09.2017, p. 114-124.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Philadelphia Telemedicine Glaucoma Detection and Follow-up Study

T2 - Methods and Screening Results

AU - Hark, Lisa A.

AU - Katz, L. Jay

AU - Myers, Jonathan S.

AU - Waisbourd, Michael

AU - Johnson, Deiana

AU - Pizzi, Laura

AU - Leiby, Benjamin E.

AU - Fudemberg, Scott J.

AU - Mantravadi, Anand V.

AU - Henderer, Jeffrey D.

AU - Zhan, Tingting

AU - Molineaux, Jeanne

AU - Doyle, Vance

AU - Divers, Meskerem

AU - Burns, Christine

AU - Murchison, Ann P.

AU - Reber, Shae

AU - Resende, Arthur

AU - Bui, Thien Dan V.

AU - Lee, Jane

AU - Crews, John E.

AU - Saaddine, Jinan B.

AU - Lee, Paul P.

AU - Pasquale, Louis R.

AU - Haller, Julia A.

PY - 2017/9/1

Y1 - 2017/9/1

N2 - 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.

AB - 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.

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