Philadelphia Telemedicine Glaucoma Detection and Follow-up Study: Methods and Screening Results
Philadelphia Telemedicine Glaucoma Detection and Follow-up Study: Methods and Screening Results
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DOI：
10.1016/j.ajo.2017.06.024
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发表时间：
2017-09-01
影响因子：
4.2
通讯作者：
Haller, Julia A.
中科院分区：
文献类型：
--
作者：
Hark, Lisa A.;Katz, L. Jay;Haller, Julia A.
目的：描述费城远程医疗青光眼检测和随访研究的方法和筛查结果。设计：筛选前瞻性随机临床试验的方案结果。方法：招募年龄在40岁以上的非裔美国人、西班牙裔/拉丁裔或亚洲人；65岁以上的白人；年龄在40岁以上有青光眼或糖尿病家族史的人群。使用初级保健办公室和联邦合格保健中心进行远程医疗（访问1）。使用无散光、自动对焦、手持式眼底相机（Volk Optical, Mentor, Ohio， USA），对每位参与者每只眼睛拍摄两张眼底后段照片和一张眼底前段照片。获得医疗和眼部病史、青光眼家族史、视力和使用ICare反弹眼压计（ICare，赫尔辛基，芬兰）测量的眼压。图像由训练有素的视网膜读取器和青光眼专家远程读取。结果：从2015年4月1日至2017年2月6日，906人同意并参加了访问1。其中，553名参与者是女性（61.0%），550名是非裔美国人（60.7%），平均年龄为58.7岁。共有532人（58.7%）患有糖尿病，616人（68%）有高血压病史。在访问期间，1356名（39.3%）参与者被分级为正常图像。使用较差眼的图像数据，333例（36.8%）异常，155例（17.1%）不可读。258例（28.5%）有可疑神经，62例（6.8%）有高眼压，102例（11.3%）有糖尿病视网膜病变，68例（7.5%）有其他视网膜异常。结论：在初级保健办公室和联邦合格医疗中心进行综合远程医疗筛查干预，发现可疑视神经、高眼压和视网膜病理的高发率。(C) 2017爱思唯尔公司版权所有。
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. (C) 2017 Elsevier Inc. All rights reserved.