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:
Footwear’s (carbon) footprint
23.05.2013 | Massachusetts Institute of Technology
Rate of bicycle-related fatalities significantly lower in states with helmet laws
23.05.2013 | Boston Children's Hospital
This morning at 05:45 CEST, the earth trembled beneath the Okhotsk Sea in the Pacific Northwest. The quake, with a magnitude of 8.2, took place at an exceptional depth of 605 kilometers.
Because of the great depth of the earthquake a tsunami is not expected and there should also be no major damage due to shaking.
Professor Frederik Tilmann of the GFZ German Research Centre for Geosciences: "The epicenter is exceptionally deep, far below the earth's crust in the mantle. Such strong ...
The Ring Nebula's distinctive shape makes it a popular illustration for astronomy books. But new observations by NASA's Hubble Space Telescope of the glowing gas shroud around an old, dying, sun-like star reveal a new twist.
"The nebula is not like a bagel, but rather, it's like a jelly doughnut, because it's filled with material in the middle," said C. Robert O'Dell of Vanderbilt University in Nashville, Tenn.
He leads a research team that used Hubble and several ground-based telescopes to obtain the best view yet of ...
New indicator molecules visualise the activation of auto-aggressive T cells in the body as never before
Biological processes are generally based on events at the molecular and cellular level. To understand what happens in the course of infections, diseases or normal bodily functions, scientists would need to examine individual cells and their activity directly in the tissue.
The development of new microscopes and fluorescent dyes in ...
A fried breakfast food popular in Spain provided the inspiration for the development of doughnut-shaped droplets that may provide scientists with a new approach for studying fundamental issues in physics, mathematics and materials.
The doughnut-shaped droplets, a shape known as toroidal, are formed from two dissimilar liquids using a simple rotating stage and an injection needle. About a millimeter in overall size, the droplets are produced individually, their shapes maintained by a surrounding springy material made of polymers.
Droplets in this toroidal shape made ...
Frauhofer FEP will present a novel roll-to-roll manufacturing process for high-barriers and functional films for flexible displays at the SID DisplayWeek 2013 in Vancouver – the International showcase for the Display Industry.
Displays that are flexible and paper thin at the same time?! What might still seem like science fiction will be a major topic at the SID Display Week 2013 that currently takes place in Vancouver in Canada.
High manufacturing cost and a short lifetime are still a major obstacle on ...
24.05.2013 | Life Sciences
24.05.2013 | Ecology, The Environment and Conservation
24.05.2013 | Physics and Astronomy
17.05.2013 | Event News
15.05.2013 | Event News
08.05.2013 | Event News