Feasibility of screening for high-risk age-related macular degeneration with an Internet-based automated fundus camera.

BACKGROUND AND OBJECTIVE: The objective of this pilot study was to determine whether a new screening system, the DigiScope (EyeTel Imaging, Inc., Columbia, MD), can detect the presence of age-related macular degeneration (AMD) at a level requiring referral to an ophthalmologist for further evaluation and possible treatment. PATIENTS AND METHODS: The DigiScope is an Internet-based semi-automated digital imaging system designed to be in primary care physicians' offices. Forty-two eyes of 21 patients with different categories of AMD were imaged with both the DigiScope and a standard color fundus camera. The imaging capability of the two modalities was compared for identification of lesions associated with AMD and classification into stages. RESULTS: There was good agreement for low-risk lesions and excellent agreement for high-risk lesions. Thirty-five of 36 eyes with intermediate or advanced disease were correctly identified with DigiScope images. Choroidal neovascularization was identified in all cases with the DigiScope due to the presence of subretinal hemorrhage or subretinal fibrosis. The DigiScope was found less capable of detecting subretinal fluid than standard stereo fundus photographs. CONCLUSIONS: This pilot study suggests that the DigiScope may be a useful screening tool for AMD.