Manhattan Vision Screening and Follow-Up Study: (NYC-SIGHT)Tele-Retinal Image Findings and Importance of Photography

Area of Science:

• Ophthalmology
• Public Health
• Medical Technology

Background:

• Community-based eye health outreach is crucial for at-risk urban populations.
• Telemedicine offers a potential solution to improve access to specialized eye care.
• The Manhattan Vision Screening and Follow-up Study (NYC-SIGHT) investigated telemedicine's role in detecting retinal abnormalities.

Purpose of the Study:

• To describe tele-retinal abnormality findings in an at-risk urban population.
• To evaluate the effectiveness of community-based telemedicine eye screening.
• To identify factors associated with abnormal retinal findings requiring ophthalmology referral.

Main Methods:

• A 5-year prospective, cluster-randomized clinical trial.
• Recruitment of individuals aged 40+ from affordable housing and senior centers.
• On-site screening including visual acuity, intraocular pressure, and telemedicine-graded fundus photography.

Main Results:

• 157 participants had retinal abnormalities, predominantly older adults (mean age 68.4 years), females, African Americans, and Hispanics.
• 32 participants had ocular pathology missed by standard vision and IOP screening but detected via fundus photography.
• Preexisting glaucoma and severe vision impairment were significantly associated with abnormal retinal images (OR=3.75 and OR=4.10, respectively).

Conclusions:

• Community-based telemedicine screening effectively detects significant retinal abnormalities in at-risk populations.
• Fundus photography is essential for comprehensive eye health screenings, identifying conditions missed by basic tests.
• This study highlights the importance of accessible eye care strategies using telemedicine in urban settings.