A Wake Forest University Baptist Medical Center team is launching a high-tech study to determine if early screening using a special camera and images transmitted over the Internet can prevent blindness in Medicaid patients with diabetes.
"Medicaid patients are rarely screened and are at risk of becoming blind," said Ramon Velez, M.D., M. Sc., the principal investigator. Diabetes is the leading cause of preventable blindness in the United States and Velez said the study will determine if early referral to ophthalmologists will help.
The project – "I See in NC" – is being pilot-tested at Downtown Health Plaza of Baptist Hospital, where Velez is medical director, and then will be offered to two rural networks of Community Care of North Carolina. One is Central Piedmont Access II, the other is Access III of the Lower Cape Fear. About 2,000 Medicaid adults with diabetes will be asked to participate.
The other networks of Community Care will get the usual treatment, and Velez and his colleagues will determine whether the screening indeed reduces blindness among patients with diabetic retinopathy because ophthalmologists can act early. Diabetes can lead to changes in blood vessels in the retina called diabetic retinopathy.
Digital photography is the key to the proposal. Trained nurses will take retinal photographs using a special digital camera, and the digital images will be transmitted over the Internet and read at a new screening center at Wake Forest University School of Medicine, Velez said.
The project is being supported by a $465,034 grant from the Duke Endowment to establish the reading center; a $456,203 grant from the Kate B. Reynolds Charitable Trust will pay for the screening in the two networks, and the North Carolina Rural Health Foundation will pay for evaluation.
Velez said Medicaid data would be used to follow the patient outcomes in both the screening group and in the controls.
"Adults with diabetes continue to go blind despite the availability of effective treatment for sight-threatening diabetic retinopathy," said Velez. "These cases of blindness are partially attributable to the low levels of screening. Screening identifies changes in the eye that the patient may not recognize. If treated early, blindness can be prevented."
But, he said, among Medicare patients who have diabetes, more that 30 percent do not get the recommended annual eye screening examination by ophthalmologists. The rate of screening among N.C. Medicaid patients is about 14 percent.
"Primary care physicians rarely perform dilated eye examinations, and the reliability of their examination has been shown to be low," said Velez, a professor of medicine at Wake Forest University School of Medicine and a primary care physician himself. "A recent review of diabetic patients at the Downtown Health Plaza showed that fewer than 20 percent reported having been to an ophthalmologist in the previous three years."
He said that taking retinal photographs in primary care settings is a potential alternative to early testing by ophthalmologists. He said that early trials using film or Polaroid cameras had been effective.
"The recent development of digital retinal photography has spurred a movement to employ this new technology with images transmitted by the Internet to central reading centers," Velez said.
He said that in the pilot testing stage, the team is using a Canon retinal camera, acquired through a grant from the North Carolina Lions Foundation. A diabetic retinopathy reading center is being established at the School of Medicine in cooperation with the Department of Ophthalmology. William P. Moran, M.D., formerly head of the Section on General Internal Medicine, is co-investigator.
Karen Richardson | Source: EurekAlert!
Further information: www.wfubmc.edu
More articles from Studies and Analyses:
Study uncovers new evidence for assessing tsunami risk from very large volcanic island landslides
11.12.2013 | National Oceanography Centre
Money may corrupt, but thinking about time can strengthen morality
11.12.2013 | Association for Psychological Science
The molecular architecture of three key proteins and their complexes reveals how plants fine-tune their immune response to pathogens
Plants rarely get sick in their natural environment. When the threat of infection arises, a quick decision is made about the necessary countermeasures. The course is set by a protein which forms complexes with its partner proteins for this purpose.
Jane Parker from the Max Planck Institute for Plant Breeding ...
Researchers studying speciation of butterfly orchids on the Azores have been startled to discover that the answer to a long-debated question "Do the islands support one species or two species?" is actually "three species".
Hochstetter's Butterfly-orchid, newly recognized following application of a battery of scientific techniques and reveling in a complex taxonomic history worthy of Sherlock Holmes, is arguably Europe's rarest orchid species. Under threat in its mountain-top retreat, the orchid urgently requires conservation recognition.
A lavishly illustrated publication, titled "Systematic revision of Platanthera in ...
Researchers from Brown University and the University of Hawaii have found some mineralogical surprises in the Moon's largest impact crater.
Data from the Moon Mineralogy Mapper that flew aboard India's Chandrayaan-1 lunar orbiter shows a diverse mineralogy in the subsurface of the giant South Pole Aitken basin.
The differing mineral signatures could be reflective of the minerals dredged up at the time of the giant impact 4 billion years ago, ...
In power electronics systems bonded connections create the central electrical connections between adjoining surfaces.
The quality of these bonded connections is one of the main factors that determines the reliability and availability of drive systems in electric vehicles, and hence constitutes a major design challenge for German auto manufacturers aiming to electrify their vehicles.
Now the partners participating in the RoBE (Robust Bonds in ...
International team of scientists develops new feedback method for optimizing the laser pulse shapes used in the control of chemical reactions
In many ways, traditional chemical synthesis is similar to cooking. To alter the final product, you can change the ingredients or their ratio, change the method of mixing ingredients, or change the temperature or pressure of the environment of the ingredients.
Like an accomplished chef, chemists have become very skilled ...
11.12.2013 | Information Technology
11.12.2013 | Life Sciences
11.12.2013 | Agricultural and Forestry Science
11.12.2013 | Event News
10.12.2013 | Event News
05.12.2013 | Event News