Browsing by Author "Keenan, Jeremy D"
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- ItemAccuracy and reliability of remote retinopathy of prematurity diagnosis.(2006-03-14) Chiang, Michael F; Keenan, Jeremy D; Starren, Justin; Du, Yunling E; Schiff, William M; Barile, Gaetano R; Li, Joan; Johnson, Rose Anne; Hess, Ditte J; Flynn, John TTo determine the accuracy and reliability of retinopathy of prematurity ROP diagnosis using remote review of digital images by 3 masked ophthalmologist readers
- ItemAssessment of image-based technology: impact of referral cutoff on accuracy and reliability of remote retinopathy of prematurity diagnosis.(2006-06-16) Chiang, Michael F; Keenan, Jeremy D; Du, Yunling E; Schiff, William; Barile, Gaetano; Li, Joan; Hess, Ditte J; Johnson, Rose Anne; Flynn, John T; Starren, JustinTelemedicine has potential to improve the delivery quality and accessibility of ophthalmic care for infants with Retinopathy of Prematurity ROP Using a telemedicine screening strategy three potential diagnostic cutoffs may be used to define disease that warrants ophthalmologic referral presence of any ROP presence of moderate type 2 prethreshold ROP or presence of severe ROP requiring treatment This study examines the relationship between accuracy and reliability of diagnosis by three masked ophthalmologist graders at each of these diagnostic cutoffs The sensitivity specificity inter grader reliability and intra grader reliability showed significant variation depending on the diagnostic cutoff with best results at cutoffs of type 2 prethreshold ROP or treatment requiring ROP Before the large scale adoption of telemedicine for image based screening of diseases such as ROP standards defining clinically relevant referral cutoffs must be established and diagnostic accuracy and reliability at these cutoffs must be characterized
- ItemCost-utility analysis of telemedicine and ophthalmoscopy for retinopathy of prematurity management.(2008-04-16) Jackson, Kevin M; Scott, Karen E; Graff Zivin, Joshua; Bateman, David A; Flynn, John T; Keenan, Jeremy D; Chiang, Michael FTo evaluate the cost effectiveness of telemedicine and standard ophthalmoscopy for retinopathy of prematurity ROP management
- ItemA mobile phone-based retinal camera for portable wide field imaging.(2014-03-21) Maamari, Robi N; Keenan, Jeremy D; Fletcher, Daniel A; Margolis, Todd PDigital fundus imaging is used extensively in the diagnosis monitoring and management of many retinal diseases Access to fundus photography is often limited by patient morbidity high equipment cost and shortage of trained personnel Advancements in telemedicine methods and the development of portable fundus cameras have increased the accessibility of retinal imaging but most of these approaches rely on separate computers for viewing and transmission of fundus images We describe a novel portable handheld smartphone based retinal camera capable of capturing high quality wide field fundus images The use of the mobile phone platform creates a fully embedded system capable of acquisition storage and analysis of fundus images that can be directly transmitted from the phone via the wireless telecommunication system for remote evaluation
- ItemNovel telemedicine device for diagnosis of corneal abrasions and ulcers in resource-poor settings.(2014-07-11) Maamari, Robi N; Ausayakhun, Somsanguan; Margolis, Todd P; Fletcher, Daniel A; Keenan, Jeremy D
- ItemTelemedicine diagnosis of cytomegalovirus retinitis by nonophthalmologists.(2014-09-12) Yen, Michael; Ausayakhun, Somsanguan; Chen, Jenny; Ausayakhun, Sakarin; Jirawison, Choeng; Heiden, David; Holland, Gary N; Margolis, Todd P; Keenan, Jeremy DCytomegalovirus CMV retinitis continues to be a leading cause of blindness in many developing countries Telemedicine holds the potential to increase the number of people screened for CMV retinitis but it is unclear whether nonophthalmologists could be responsible for interpreting fundus photographs captured in a telemedicine program
- ItemTelemedicine Screening for Cytomegalovirus Retinitis at the Point of Care for Human Immunodeficiency Virus Infection.(2014-11-20) Jirawison, Choeng; Yen, Michael; Leenasirimakul, Prattana; Chen, Jenny; Guadanant, Siripim; Kunavisarut, Paradee; Patikulsila, Direk; Watanachai, Nawat; Ausayakhun, Somsanguan; Heiden, David; Holland, Gary N; Margolis, Todd P; Keenan, Jeremy DCytomegalovirus CMV retinitis is a leading cause of blindness in many developing countries likely the result of inadequate screening Telemedicine screening for CMV retinitis instituted at the point of care for human immunodeficiency virus HIV infection may allow for earlier detection
- ItemVisual acuity outcomes in cytomegalovirus retinitis: early versus late diagnosis.(0000-00-00) Ausayakhun, Somsanguan; Yen, Michael; Jirawison, Choeng; Ausayakhun, Sakarin; Khunsongkiet, Preeyanuch; Leenasirimakul, Prattana; Kamphaengkham, Siripim; Snyder, Blake M; Heiden, David; Holland, Gary N; Margolis, Todd P; Keenan, Jeremy DAIMS To determine if early dilated fundus examination for cytomegalovirus CMV retinitis leads to better visual outcomes in areas with limited HIV care where patients may have long standing retinitis before they are diagnosed with HIV METHODS Twenty four eyes of 17 patients with CMV retinitis who were seen at an urban HIV clinic in Chiang Mai Thailand were included in this retrospective cohort study Participants were divided into two groups based on the amount of time from the first documented CD4 count below 100 cells mm3 to the first eye examination for CMV retinitis Average visual acuity in each group was calculated at the time CMV retinitis was first detected and then at 3 6 and 12 months after diagnosis RESULTS The group of patients who received an eye examination within approximately 4 months of the initial low CD4 count measurement had better baseline visual acuity median 20 30 IQR 20 20 to 20 60 compared with patients who presented later median 20 80 20 60 to hand motion p 0 03 Visual acuity did not change significantly during the 12 month study period in either the early group p 0 69 or late group p 0 17 CONCLUSION In this study patients who were examined sooner after a low CD4 count had better vision than patients who were examined later Routine early screening of patients with CD4 counts under below 100 cells mm3 may detect earlier disease and prevent vision loss