Featured Research

from universities, journals, and other organizations

Remote screening can help detect diabetic eye disease

Date:
February 25, 2014
Source:
Wolters Kluwer Health: Lippincott Williams & Wilkins
Summary:
An Internet-based screening approach performs well in identifying patients with treatable diabetic eye disease, according to a study. using digital photographs of the eye taken at the doctor's office or clinic, eye specialists can reliably detect "hard exudates" -- a key early sign of diabetes-related macular edema, reports the new research. This macular edema is one of the most serious vision-threatening changes in the eyes of people with diabetes.

An Internet-based screening approach performs well in identifying patients with treatable diabetic eye disease, according to a study in Optometry and Vision Science, official journal of the American Academy of Optometry. The journal is published by Lippincott Williams & Wilkins, a part of Wolters Kluwer Health.

In the article, "Utility of Hard Exudates for the Screening of Macular Edema," using digital photographs of the eye taken at the doctor's office or clinic, eye specialists can reliably detect "hard exudates" -- a key early sign of diabetes-related macular edema, reports the new research by Jorge A. Cuadros, OD, PhD, of UC Berkeley School of Optometry and colleagues. "This study offers impressive support for the implementation of remote screening images for patients with diabetes, who are not being seen by eye specialists like optometrists and ophthalmologists," comments Anthony Adams, OD, PhD, Editor-in-Chief of Optometry and Vision Science.

Remote Detection of Hard Exudates in Eye Photographs

The researchers evaluated the use of the EyePACS "tele-ophthalmology" system to detect edema (wetness) resulting from leaky blood vessels in the retina at the back of the eye. This macular edema is one of the most serious vision-threatening changes in the eyes of people with diabetes.

"Edema that is detected close to the line of sight (straight-ahead vision) can and should be treated to slow or avoid any loss of vision," explains Dr Adams. "However about one-third of all people with diabetes don't realize they have diabetes and about 20 percent of those with recently diagnosed already have some changes in the blood vessels at the back of the eye."

Optometrists and ophthalmologists, with specialized training and instruments, can diagnose macular edema. However, these services aren't available or practical everywhere. In EyePACS and similar remote screening programs, primary care doctors or nurses take digital photographs of the eye, which are then sent for remote viewing and diagnosis by an optometrist or ophthalmologist.

One sign these specialists look for is small yellow "hard exudates" -- an indicator of current or very recent edema. In their study, Dr Cuadros and coauthors sought to determine whether hard exudates in clinic photographs are an accurate indicator of clinically significant macular edema in patients with diabetes.

Sensitive Screening Test for Diabetic Eye Disease

The study included 103 adults with type 2 diabetes, seen at a public health clinic, who were considered at high risk for macular edema. A special digital camera was used to take a magnified view of the interior of the eye, without the use of eye drops to dilate the pupil. The photos were sent over the Internet for review by eye specialists, who looked for hard exudates close to the line of sight as an indicator of clinically significant macular edema.

Within a few months, patients returned to the clinic for specialist examination, including dilation of the pupil and stereo views of the interior of the eye -- the standard test for diabetic eye disease. The dilated exams showed clinically significant macular edema in about 15 percent of patients.

Hard exudates detected on the digital photographs were an accurate indicator of macular edema. "The presence of hard exudates allowed correct detection of actual edema close to 90 percent of the time," says Dr Adams. "Just as important, the test was close to 80 percent accurate in correctly identifying when no edema was present." Thus the screening procedure had a sensitivity of 90 percent and specificity of 80 percent.

To prevent vision loss, it's important to identify and treat diabetic eye damage as early as possible. Remote screening tests have been developed to increase the number of diabetic patients screened for eye disease. That's especially important in groups without access to specialist vision care, like the public clinic patients evaluated in the new study. Dr Cuadros is inventor of the EyePACS system, which is used to screen nearly 36,000 patients each year at the UC Berkeley School of Optometry Digital Health Clinic.

Although further research is needed, the new results show that that remote screening -- and specifically the detection of hard exudates in nondilated eye photographs -- can accurately identify patients with diabetic eye disease. Dr Cuadros and coauthors conclude, "Low-cost and reliable methods of detecting clinically significant macular edema, such as the use of a hard exudate surrogate marker described here, are needed to meet the challenge of widespread screening for this vision-threatening condition."


Story Source:

The above story is based on materials provided by Wolters Kluwer Health: Lippincott Williams & Wilkins. Note: Materials may be edited for content and length.


Journal Reference:

  1. Taras V. Litvin, Glen Y. Ozawa, George H. Bresnick, Jorge A. Cuadros, Matthew S. Muller, Ann E. Elsner, Thomas J. Gast. Utility of Hard Exudates for the Screening of Macular Edema. Optometry and Vision Science, 2014; 1 DOI: 10.1097/OPX.0000000000000205

Cite This Page:

Wolters Kluwer Health: Lippincott Williams & Wilkins. "Remote screening can help detect diabetic eye disease." ScienceDaily. ScienceDaily, 25 February 2014. <www.sciencedaily.com/releases/2014/02/140225111816.htm>.
Wolters Kluwer Health: Lippincott Williams & Wilkins. (2014, February 25). Remote screening can help detect diabetic eye disease. ScienceDaily. Retrieved September 30, 2014 from www.sciencedaily.com/releases/2014/02/140225111816.htm
Wolters Kluwer Health: Lippincott Williams & Wilkins. "Remote screening can help detect diabetic eye disease." ScienceDaily. www.sciencedaily.com/releases/2014/02/140225111816.htm (accessed September 30, 2014).

Share This



More Health & Medicine News

Tuesday, September 30, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

How 'Yes Means Yes' Defines Sexual Assault

How 'Yes Means Yes' Defines Sexual Assault

Newsy (Sep. 29, 2014) Aimed at reducing sexual assaults on college campuses, California has adopted a new law changing the standard of consent for sexual activity. Video provided by Newsy
Powered by NewsLook.com
Scientists May Have Found An Early Sign Of Pancreatic Cancer

Scientists May Have Found An Early Sign Of Pancreatic Cancer

Newsy (Sep. 29, 2014) Researchers looked at 1,500 blood samples and determined people who developed pancreatic cancer had more branched chain amino acids. Video provided by Newsy
Powered by NewsLook.com
Colo. Doctors See Cluster of Enterovirus Cases

Colo. Doctors See Cluster of Enterovirus Cases

AP (Sep. 29, 2014) Doctors at the Children's Hospital of Colorado say they have treated over 4,000 children with serious respiratory illnesses since August. Nine of the patients have shown distinct neurological symptoms, including limb weakness. (Sept. 29) Video provided by AP
Powered by NewsLook.com
Dr.'s Unsure of Cause of Fast-Spreading Virus

Dr.'s Unsure of Cause of Fast-Spreading Virus

AP (Sep. 29, 2014) Doctors at the Children's Hospital of Colorado say they have treated over 4,000 children with serious respiratory illnesses since August. Nine of the patients have shown distinct neurological symptoms, including limb weakness. (Sept. 29) Video provided by AP
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:

Strange & Offbeat Stories


Health & Medicine

Mind & Brain

Living & Well

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins