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Screening the Retina for Heart Disease/Stroke (talkingeyes®)

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Digital Teleretinal Screening

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Abstract

In 2030, the fraction of German citizens at the age of 65 years or older will increase to a percentage of 33% from today of 16%. Stroke will double to about 285,000 persons per year, and in 2030, the costs for this vascular disease will increase to more than 15 billion Euro/year.

The purpose was to examine telemedically the retinal vasculature in patients of general practitioners. The medical goal of this approach was to help optimize the antihypertensive blood pressure therapy by adding information about microangiopathic changes in the retinal vessels.

In 2001, the telemedicine-based and interdisciplinary prevention program for vascular diseases (“talkingeyes®”) started, using mobile fundus cameras. The participants were patients of general practitioners in private practice and occupational physicians of companies. Since 2001, within the program, more than 60,000 subjects were examined telemedically to detect microangiopathic changes in the retinal microvasculature.

Several mobile, non-mydriatic fundus cameras were located at offices of general practitioners or in health-care centers of the cooperating companies. The patients were examined in several aspects to detect vascular risk factors or early signs of vascular diseases. 45°-photography of the retina with a non-mydriatic digital fundus camera was performed, the medical history was recorded, and blood markers and blood pressure were measured and documented to calculate the PROCAM-index. The analysis of the fundus images was telemedically accomplished by eye doctors. After telemedical assessment of all data and images, an automated medical report was generated.

In this chapter, we describe the analysis of a group of 6,999 patients. This group has had a mean age of 55 and a range of 15 years. The patients reported arterial hypertension in 40%, stroke in 2.9%, and cardiac infarction in 3.0%. We found 9% relevant morphological changes in retinal vessels like arteriovenous compression, retinal bleedings, microaneurysms, or microinfarcts. In 2% of patients, we estimated a PROCAM-index indicating a high risk to develop a cardiovascular event. In 55 out of 6,999 patients (0.8%), we found relevant retinal microangiopathic changes while the PROCAM-index has indicated no risk with respect to cardiovascular events.

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Authors and Affiliations

  1. Department of Ophthalmology, Friedrich-Alexander-University of Erlangen-Nuremberg, Erlangen, Germany

    Georg Michelson M.D.

  2. Interdisciplinary Center of Ophthalmic Preventive Medicine and Imaging, Friedrich-Alexander-University of Erlangen-Nuremberg, Schwabachanlage 6, D-91054, Erlangen, Germany

    Georg Michelson M.D.

  3. Priva Center of Preventive Medicine, Am Stadtpark 2, Nürnberg, Germany

    Martin Laser M.D.

Authors
  1. Georg Michelson M.D.
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  2. Martin Laser M.D.
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Corresponding author

Correspondence to Georg Michelson M.D. .

Editor information

Editors and Affiliations

  1. CSIRO, e-Health Research Centre, Centre for Ophthalmology and, University of Western Australia, Brockway Road 65, Floreat, 6009, West Australia, Australia

    Kanagasingam Yogesan

  2. Veterans Affairs, Medical Informatics, United States Department of, Miranda Ave. 3801, Palo Alto, 94304, California, USA

    Leonard Goldschmidt

  3. School of Optometry, University of California, Minor Hall 200, Berkeley, 94720-2020, California, USA

    Jorge Cuadros

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© 2012 Springer-Verlag Berlin Heidelberg

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Michelson, G., Laser, M. (2012). Screening the Retina for Heart Disease/Stroke (talkingeyes®). In: Yogesan, K., Goldschmidt, L., Cuadros, J. (eds) Digital Teleretinal Screening. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-25810-7_10

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  • DOI: https://doi.org/10.1007/978-3-642-25810-7_10

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  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-25809-1

  • Online ISBN: 978-3-642-25810-7

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