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• W4255202506 abstract "<sec> <title>BACKGROUND</title> While teleophthalmology is gaining traction in recent years, it is taking center stage in the COVID-19 pandemics. However, most hospitals are yet ready due to a severe lack of real-world experience. Furthermore, there are limited number of studies evaluating the telemedicine application on remote islands. </sec> <sec> <title>OBJECTIVE</title> To evaluate the real-world clinical and referral accuracy, image quality, physician perceived diagnostic certainty, and patient satisfaction of a telemedicine eye screening using a novel handheld fundus camera in a rural and medically underserved population. </sec> <sec> <title>METHODS</title> This prospective study enrolled 176 eyes from a remote island. All participants underwent a comprehensive ophthalmic examination. Nonmydriatic retinal images obtained using a handheld fundus camera were reviewed by two retinal specialists to determine the image quality, diagnosis, and need for referrals. The agreement of diagnosis between image-based assessments was compared to that of binocular indirect ophthalmoscopic assessment. </sec> <sec> <title>RESULTS</title> Image quality of fundus photograph was considered ideal or acceptable in 97.7% and 95.5% eyes. There was considerable agreement in diagnosis between the indirect ophthalmoscopic assessment and image-based assessment by two reviewers (Cohen’s kappa=0.80 and 0.78, respectively). Likewise, substantial agreement in referrals was achieved. The sensitivity for referable retinopathy from the two reviewers was 78% [95% CI, 57%-91%] and 78% [95% CI, 57%-91%], whereas specificity was 99% [95% CI, 95%-99%] and 98% [95% CI, 93%-99%], respectively. For physician perceived certainty in diagnosis, 93.8% and 90.3% were considered either certain or reliable. Overall, 97.4% of participants were satisfied with their experience and greatly valued the telemedicine service. </sec> <sec> <title>CONCLUSIONS</title> The novel fundus camera-based telemedicine screening demonstrated high accuracy in detecting clinically significant retinopathy in real-world settings. It achieved high patient satisfaction and physician perceived certainty in diagnosis with reliable image quality, which may be scaled internationally to overcome the geographical barriers under global pandemic. </sec> <sec> <title>CLINICALTRIAL</title> N/A </sec>" @default.
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• W4255202506 date "2020-12-14" @default.
• W4255202506 modified "2023-09-23" @default.
• W4255202506 title "Implementation of a Teleophthalmology Screening Network Using a Novel Handheld Fundus Camera on a Remote Island: Physician and Patient Perceptions from Real World Experience (Preprint)" @default.
• W4255202506 doi "https://doi.org/10.2196/preprints.26502" @default.
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