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    Portable non-mydriatic device closes gap on tele-glaucoma screening

    Imaging system can help patients in remote areas, those not able to reach centers

     

    Researchers did a cross-sectional study of 422 eyes from 211 new patients recruited from the glaucoma clinic at Kathmandu, Nepal’s Tilganga Institute of Ophthalmology.

    First, a glaucoma specialist evaluated all subjects by performing a dilated fundus exam and standard automated perimetry to establish a glaucoma diagnosis.

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    “Fundus photographs were taken using both the handheld camera [Pictor] before dilation and a tabletop fundus camera [Topcon] after dilation for comparison,” Dr. Newman-Casey said.

    Then, two masked glaucoma specialists graded the images for a cup-to-disc ratio. Overall, there was no significant difference in ophthalmologists’ cup-to-disc ratio grade between the portable and standard cameras.

    However, glaucoma could not be accurately diagnosed based on fundus photographs alone, Dr. Newman-Casey said—a finding in-line with other published research.

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    “The Pictor had a sensitivity of 48.1% to 61.5% and specificity of 44.1% to 62.8% to remotely diagnose glaucoma when compared with the clinical examination,” the authors wrote in their abstract. “Similarly, the Topcon had a sensitivity of 47.5% to 53.9% and specificity of 55.6% to 64.2% when compared with clinical examination.”

    Benefits outweigh challenges

    Still, the overall results pleased researchers because they have found it reasonable to use portable camera to take fundus photographs as part of glaucoma screening in remote areas. The results are also positive because the camera does not require the time-consuming task of dilation.

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    Even physicians in the United States should take note of the results, Dr. Newman-Casey said, as portable screening could come in handy at hospitals or nursing homes.

    There are some considerations with use of a portable fundus camera, Dr. Newman-Casey said. It takes some training to get to know how to use the camera, and continuous practice is required so images will be of the right quality.

    “As the technology evolves, we hope that new solutions will become available that are easier to use,” she said.

    Glaucoma 360: New approaches and technologies offer hope in vision restoration

    Click here for more glaucoma updates from the 2016 Glaucoma 360 meeting!

     

    Paula Anne Newman-Casey, MD, MS

    E: [email protected]

    This article was adapted from Dr. Newman-Casey’s presentation at the 2016 meeting of the Association for Research in Vision and Ophthalmology. Dr. Newman-Casey did not indicate any proprietary interest in the subject matter.

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