Telemedicine improves treatment for eye diseases

Telemedicine, made possible with high speed Internet access, has been found to improve treatment of different types of eye diseases, according to the American Academy of Ophthalmology.

Two studies, both of which are being presented at the American Academy of Ophthalmology's 2007 Annual Meeting, strongly suggest that utilizing telemedicine can improve both patient compliance and patient access to quality care.

The first study focused on patients with diabetes, who are recommended to have an annual retinal examination. The year before the installation of a telemedicine remote imaging system, only 15 percent of 1,257 patients in the study had the examination. The next year, after the remote imaging system was installed, 71 percent of 1,395 patients had the recommended examination.

This dramatic increase was caused by the new telemedicine options, which the study estimated accounted for 33 percent of the increase, as well as an increased of overall awareness of the problem -- partly spurred by the telemedicine program -- which accounted for 66 percent of the increase.

"In the past, it has been shown that telemedicine is technically possible, but this study demonstrates the true impact of a telemedicine system on the number of patients with diabetes who end up having an evaluation for diabetic retinopathy," said Ingrid Zimmer-Galler, MD, assistant professor of ophthalmology at the Wilmer Eye Institute at the Johns Hopkins School of Medicine. "With this system, we've dramatically increased the rate of annual retinal evaluations."

The second study to be presented addressed screening premature infants for retinal diseases using traditional methods as compared to screening infants using telemedicine techniques.

"The number of premature infants is increasing throughout the world, and a larger percentage of them are surviving," said Michael Chiang, MD, assistant professor of ophthalmology and biomedical informatics at the Columbia University College of Physicians and Surgeons and presenting author of the paper. "The challenge is how do we make good care accessible to these babies. The purpose of this study was to see how well the results of telemedicine compared to those of an ophthalmoscopic examination."

Doctors examined the eyes of 67 prematurely born infants and recorded diagnoses. Four to twelve months later, the same doctors looked at retinal images taken of those same eyes shortly after their initial examination, and were asked to diagnose them once again.

After minimizing all chances that the examiner could recall the previous diagnosis of the eyes, the doctors issued diagnoses based off the images which matched exactly with the previous diagnoses 86 percent of the time. There were 12 cases where there was a significant discrepancy in the diagnoses, and Dr. Chiang suggests that the telemedicine diagnosis method was more accurate.

"Telemedicine exam may be more reproducible than if you see an infant's retina only briefly during ophthalmoscopy," he says. "There is a rationale that image-based examination may be better because findings are documented photographically. In many other ophthalmic diseases, definitions are based on standard images, so this has implications for the way we might deliver the best care to patients in the future."

These two studies represent just a few ways in which telemedicine has the potential to change and improve medicine, as well as bring resources into reach for patients all over the world who were previously too remote to receive the best care available.

Research Highlights Potential Benefits Of Telemedicine In Treating Eye Disease (Medical News Today)

Telemedicine (Speed Matters)