Telemedicine for Macular Degeneration

It’s getting to the point that there’s no need to leave your home for mundane chores anymore. From buying groceries to finding the right book, all you have to do is open your phone, press a few buttons and the job is done. Now it looks like getting your prescription filled to even visiting a doctor may be another annoying task made simple with your digital device. Particularly if you have macular degeneration or other eye challenges that require multiple office visits.

It has been coined telemedicine which is the use of apps, photos, texting and email as “the remote diagnosis and treatment of patients by means of telecommunications technology”.

This new means of diagnosis and prescription could help on many levels, including:

• Treatment when distance is an issue
• Cost reduction for patient and doctor
• Immediate treatment of critical care and emergency situations

Now, telemedicine for macular degeneration and other vision challenges seems to be changing the industry for the better.

No More Excess Visits

Telemedicine brings peace of mind to older patients struggling with age-related macular degeneration (AMD). This community may have difficulty getting an appointment, being transported and then waiting to be seen for what may often only be a 10-15 minute assessment.

With some easy applications on a smartphone or even a texted photo or video in many cases an eye doctor can now determine if it is even necessary for the patient to come to the office.

In a study of 185 AMD (age-related macular degeneration) patients using telemedicine, published in the journal Investigative Ophthalmology & Visual Science (IOVS), it was concluded that,

“The telemedicine model described in this study can be a useful alternative for AMD follow-up. It is less time consuming for retina specialists than office examination and provides a more rational approach for digital image management.”

AMD Prescriptions

Some smartphone applications are so precise that some eye doctor’s can diagnose a prescription adjustment just from the app results.

Dr. Amanda Hoelscher, an optometrist at Key Whitman Eye Center in Texas comments,  “I think some of the apps are actually fairly accurate if you have a reasonable prescription,”

AMD prescriptions can be adjusted according to close observation through telemedicine. It could be particularly helpful for those undergoing anti-VEGF treatment (medications that block vascular endothelial growth factor used for macular degeneration).

MedScape reports that, according to José Andonegui Navarro, MD, from the ophthalmology service at Hospital de Navarra, in Pamplona, Spain,

“The effectiveness of vascular endothelial growth-factor [VEGF] inhibitors combined with an aging population and the chronic nature of treatment for neovascular age-related macular degeneration has led to an increasing number of patients requiring evaluation for recurrence and re-treatment. Telemedicine offers an innovative technologic solution to this clinical conundrum.”

Home monitoring offers real time perspective for treat-and-extend protocols or can determine a course of action for re-treating when as-needed protocols are considered. Rather than a weekly , an eye doctor can look at daily telemedicine records of a patient’s progress or regress.

Less Stress

With no cure for AMD, many medicines are being used to slow its progress. Yet, some of these medicines often require a specific protocol which necessitates the patient to be evaluated in-office several times per month. Most of these evaluations require a quick visual check that can easily be screened through a digital exchange which may help reduce stress levels all around.

As reported by Science Daily, according to Bradley E. Dougherty, OD, PhD, of The Ohio State University College of Optometry,

“Patients with vision loss in AMD experience high rates of stress, anxiety, and other problems, including depression…stress may be associated with increased inflammation and that AMD is an inflammatory disease — raising the possibility that stress may contribute to disease progression.”

Telemedicine reduces stressful trips to the doctor’s office which in turn may reduce the associated high stress level. When the patient simply snaps a photo of each eye and sends it to the doctor, in many cases, AMD medicines can immediately be viewed as working or not. In addition, other macular degeneration or eye conditions may also be detected.

Diabetic Retinopathy Detection

Telemedicine may help detect diabetic retinopathy which is linked to macular degeneration development. The presentation of this disease requires certain angles of assessment which older telemedicine models could not deliver, however, technology is rapidly advancing with more accurate digital deliveries currently available.

The British Journal of Ophthalmology cited the study ‘Telemedicine for detecting diabetic retinopathy: a systematic review and meta-analysis’ which concluded that,

“The diagnostic accuracy of telemedicine using digital imaging in DR [diabetic retinopathy] is overall high. It can be used widely for DR screening. Telemedicine based on the digital imaging technique that combines mydriasis [dilation of the pupil] with a wide angle field [] is the best choice in detecting the absence of DR and the presence of mild NPDR [non-proliferative (slow growing) diabetic retinopathy].”

Like any disease, early detection is paramount in a successful treatment protocol. Through continued telemedicine deliveries, diabetic retinopathy and macular degeneration may be identified before getting out of control. Some in the medical community agree.

Another study by researchers from Bascom Palmer Eye Institute, Department of Ophthalmology, University of Miami Miller School of Medicine, titled,’Feasibility of telemedicine in detecting diabetic retinopathy and age-related macular degeneration’ which was published in Seminars in Ophthalmology concluded,

“Age-related macular degeneration and diabetic retinopathy are important causes of visual impairment and blindness in the world. Because of recent advances and newly available treatment modalities along with the devastating consequences associated with late stages of these diseases, much attention has been paid to the importance of early detection and improving patient access to specialist care. Telemedicine or, more specifically, digital retinal imaging utilizing tele-medical technology has been proposed as an important alternative screening and management strategy to help meet this demand.”

Accessible Images and Info

All telemedicine images and information are stored on a secure, easily accessible server which your doctor can retrieve and compare to current images.

This comparison also saves time as it enables the eye doctor to diagnose on his or her own time rather than when a patient is waiting making for a more stress-free environment all around. For wet macular degeneration this can be essential as it is a more rapid progression and should be monitored closely.

Be on the lookout as telemedicine for macular degeneration becomes more accessible by medical practitioners. Also, talk to your ophthalmologist or eye doctor about a possible telemedicine option. If yours does not embrace this technology find a doctor that does and try it for yourself. It is important to note however that in-office visits are essential, particularly for assessment of specific applications which cannot be conveyed through telemedicine such as intraocular pressure (IOP), dry eye and astigmatism.

Next story…

Michigan Medical Doctor Creates Vision Vitamin After Diagnosed with Age Related Macular Degeneration

A medical doctor from Michigan who was diagnosed with age related macular degeneration has created his own vision vitamin, and you can now try it for FREE for a limited time.

The doctor says, “I remember the day like it was yesterday … It was June 4, 2004 when a good friend and colleague of mine said, ‘My dear friend you have the early stages of macular degeneration.’  My heart nearly skipped a beat.  As a physician I knew that this was serious and I wanted to do everything in my power to save my vision, which put me on a journey to create my own vision vitamin.”

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