Diagnosing cytomegalovirus retinitis through telemedicine in a Texas correctional institution: A pilot study

Purpose. Telemedicine is a system that uses computer and telecommunication technology as an alternative to traditional face-to-face examination. However, it is not yet clear that 2-dimensional images transmitted over computer networks to remote locations for evaluation is a viable option in the diagnosis of CMV retinitis. We studied the clinical and cost effectiveness of using teleophthalmology in the diagnosis of patients with CMV retinitis in a correctional institution with a high volume of HIV positive patients. Methods. Thirty examinations of CMV retinitis by telemedicine exam (study group) were compared with a face-to-face exam (control group) on the same day. Results. Digitized images obtained by telemedicine were compared to conventional face-to-face examination. The resolution of stored still images obtained by telemedicine will be presented. The limitations of telemedicine technique and equipment used will be discussed. Conclusions. Teleophthalmology can be a viable option to face-to-face examinations for the evaluation of CMV retinitis. The technology may help reduce the need for transporting inmates from remote prison sites to special health care facilities for monitoring the progression of retinitis. Improved access to subspecialists via telemedicine can also decrease delays in diagnoses and reduce overall costs.