Purpose. Direct ophthalmoscopes with real time video-linked capabilities are present in each of the 59 sites within the Georgia Statewide Telemedicine System. (GSTS). We performed a pilot study to determine the sensitivity and specificity of the GSTS direct ophthalmoscope in the diagnosis of diabetic retinopathy, cataract and glaucoma in patients with diabetes mellitus. Methods. Thirty-five eyes of eighteen patients with diabetes mellitus were assessed. Subjects underwent dilated, direct ophthalmoscopic fundus examination by a non-ophthalmologist physician with telemedical transmission of real time images to an ophthalmologist. A second gold standard, in-person comprehensive examination (including indirect ophthalmoscopy) was performed by an ophthalmologist. Results. Data reveals poor accuracy of direct ophthalmoscopic imaging technology (27%, 0% and 52% sensitivity for accurately diagnosing diabetic retinopathy, glaucoma suspects and visually significant cataract, respectively). Specificity was 100% for these three diseases. Conclusions. Direct ophthalmoscopic, telemedical imaging is inadequate to assess ophthalmic disorders in diabetics. Increasing lens opacity in this older population seems to decrease image resolution in comparison to other younger individuals.
|Investigative Ophthalmology and Visual Science
|Published - Feb 15 1996
ASJC Scopus subject areas
- Sensory Systems
- Cellular and Molecular Neuroscience