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Description of the Telemedical Eye Examination System Talkingeyes®
Autoren: Georg Michelson (Erlangen)

Fig 1: Prevalence of Retinal Microangiopathic Abnormalities and Optic Nerve Atrophy in “Healthy” Subjects
4 Prevalence of Retinal Microangiopathic Abnormalities and Optic Nerve Atrophy in “Healthy” Subjects D

1. Purpose: The purpose is to examine the prevalence of “simple” optic nerve atrophy, retinal microvascular narrowing and arteriovenous nicking in a normotensive, non-diabetic, “healthy” population gained by the Tele-Ophthalmic Consultation Service Talkingeyes®.

2. Methods: We investigated the prevalence of focal arteriolar narrowing, focal and generalized arteriolar narrowing, arteriovenous nicking and optic nerve atrophy in a group of non-diabetic, normotensive subjects without any systemic or ocular disease. The Tele-Ophthalmic Consultation Service Talkingeyes® was used to perform the photography of the posterior pole, and the documentation of relevant information of existing ophthalmic, internal or neurological diseases. The tele-ophthalmic evaluation of retina and optic nerve head morphology was performed by an experienced eye specialist. For the analysis we selected from the talkingeyes data base N=1662 “healthy” individuals without arterial hypertension, diabetes mellitus or any other systemic or ocular disease or stroke or heart infarction in medical history. N=785 participants were male (47%). The age ranged from 41 to 90 years .

3. Results: The prevalence of focal narrowing, generalized narrowing, arteriovenous nicking, and optic nerve atrophy in healthy subjects is strongly age-related. Figure 1 shows the age-dependencies. The prevalence of optic nerve atrophy rose from 0.8 % in decade 4 to 15.2 % in decade 8 (factor 19), the prevalence of generalized arteriolar narrowing from 3,5% in the 4th decade to 15,2% in the 8th decade (factor 4.3). The age-dependency of optic nerve atrophy, arteriovenous nicking and focal arteriolar narrowing was significant at p < 0.05.

4. Discussion and Conclusion: The tele-ophthalmic technique talkingeyes® allows a full tele-medical evaluation of the eye with telemedical evaluation of the anterior part of the visual pathway using data of the medical history, visual function and images of the cornea, the lens, the retina and optic nerve head. In healthy subjects we found that the prevalence of microvascular alterations and optic nerve atrophy was strongly age-related. The prevalences of retinal micoangiopatic changes in the retina and optic nerve head in different decades of age ranged for focal narrowing from 10-36%, for generalized narrowing from 3-15%, for arteriovenous nicking from 2%-9%, and for “simple” optic nerve atrophy from 0.8% to 15%. Thus, a telemedical evaluation of patients with respect to optic nerve pathology or microangiopathic changes should refer to age-related prevalences of healthy controls.





Chapters
1 Medical Background




2 Technical Description of Important Aspects of the Telemedical Eye Examination Systems Talkingeyes®




3 Operational Description and Medical Applications of the Telemedical Eye Examination Systems Talking




4 Prevalence of Retinal Microangiopathic Abnormalities and Optic Nerve Atrophy in “Healthy” Subjects D




5 Contact




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