Philadelphia Telemedicine Glaucoma Detection and Follow-up Study: Analysis of Unreadable Fundus Images.

Published

Journal Article

PURPOSE: The purpose of this study was to ascertain determinants of unreadable fundus images for participants enrolled in the Philadelphia Telemedicine Glaucoma Detection and Follow-up Study. METHODS: Individuals were screened for glaucoma at 7 primary care practices and 4 Federally Qualified Health Centers using telemedicine. Screening (visit 1) included fundus photography, assessing family history of glaucoma, and intraocular pressure (IOP) measurements. Participants with an unreadable image in at least one eye were deemed unreadable and invited to return for a confirmatory eye examination (visit 2). RESULTS: A total of 906 participants completed the visit 1 eye screening and 17.1% (n=155/906) were "unreadable." In the multivariable logistic regression analysis, older age, male sex, smoking, and worse visual acuity were significantly associated with an unreadable fundus image finding at the eye screening (P<0.05). Of the 89 participants who were invited for the confirmatory eye examination solely for unreadable images and attended visit 2, 58 (65.2%) were diagnosed with at least one ocular pathology. The most frequent diagnoses were cataracts (n=71; 15 visually significant, 56 nonvisually significant), glaucoma suspects (n=27), and anatomical narrow angle (n=10). CONCLUSIONS: Understanding the causes of unreadable fundus images will foster improvements in telemedicine techniques to optimize the predictive accuracy, efficiency, and cost in ophthalmology. A high proportion of participants with unreadable images (65.2%) in our study were diagnosed with some ocular pathology, indicating that the finding of an unreadable fundus image warrants a referral for a comprehensive follow-up eye examination.

Full Text

Duke Authors

Cited Authors

  • Hark, LA; Myers, JS; Rahmatnejad, K; Wang, Q; Zhan, T; Hegarty, SE; Leiby, BE; Udyaver, S; Waisbourd, M; Leite, S; Henderer, JD; Pasquale, LR; Lee, PP; Haller, JA; Katz, LJ

Published Date

  • November 2018

Published In

Volume / Issue

  • 27 / 11

Start / End Page

  • 999 - 1008

PubMed ID

  • 30180021

Pubmed Central ID

  • 30180021

Electronic International Standard Serial Number (EISSN)

  • 1536-481X

Digital Object Identifier (DOI)

  • 10.1097/IJG.0000000000001082

Language

  • eng

Conference Location

  • United States