A telemedicine program for diabetic retinopathy in a Veterans Affairs Medical Center—the Joslin Vision Network Eye Health Care Model
| Autor: | Jerry D. Cavallerano, Kristen Hock, Lloyd Paul Aiello, Anthony A Cavallerano, Paula Katalinic, Beatrice Blake, Paul R. Conlin, Lloyd M. Aiello, Ann Tolson, Michael Rynne |
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| Rok vydání: | 2005 |
| Předmět: |
Adult
Male medicine.medical_specialty genetic structures Eye disease Telepathology Diagnostic Techniques Ophthalmological Retina Cohort Studies Diabetes Complications Impaired glucose tolerance Diabetes mellitus Ophthalmology Image Processing Computer-Assisted Humans Medicine Macular edema Veterans Affairs Aged Retrospective Studies Aged 80 and over Diabetic Retinopathy business.industry Diabetic retinopathy Middle Aged medicine.disease Impaired fasting glucose United States eye diseases United States Department of Veterans Affairs Female sense organs business Delivery of Health Care Retinopathy |
| Zdroj: | American Journal of Ophthalmology. 139:597-604 |
| ISSN: | 0002-9394 |
| DOI: | 10.1016/j.ajo.2004.10.064 |
| Popis: | Purpose To extend access to diabetic eye care and characterize the extent of diabetic retinopathy {DR) and other ocular findings using the Joslin Vision Network (JVN). Design Retrospective observational cohort study. Methods Outpatients at the Togus VA Medical Center with diabetes mellitus, impaired fasting glucose, or impaired glucose tolerance underwent JVN protocol imaging. Images were transmitted to the Joslin Diabetes Center for grading and recommended treatment plan. Results The study included 1,219 patients (2,437 eyes); 1,536 eyes (63.0%) had no (DR), 389 (16.0%) had mild nonproliferative DR (NPDR), 105 (4.3%) moderate NPDR, 35 (1.4%) severe NPDR, 20 (0.8%) very severe NPDR, and 21 (0.9%) had proliferative DR (PDR). Regarding diabetic macular edema (DME), 1,907 eyes (78.3%) had no DME, 34 (1.4%) had early DME, and 16 (0.7%) had clinically significant macular edema (CSME). Of all patients, 354 (29.0%) had either no DR or mild NPDR in both eyes, no evidence of DME, and no significant nondiabetic findings; 679 (55.7%) had no DR in either eye, and 229 (18.8%) had mild NPDR in the more severe eye. Of the 908 patients (74.5%) with either no DR or mild NPDR in the more severe eye, 533 (58.7%) had at least one nondiabetic ocular finding necessitating referral. Finally, 320 eyes (13.1%) were ungradable for both DR and DME and 160 (6.6%) were ungradable for DME alone. Conclusion In a non-ophthalmic setting, JVN identifies the severity of DR and nondiabetic ocular conditions, permitting appropriate triage for eye care. |
| Databáze: | OpenAIRE |
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