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Retina Blood Vessels Predict Common Fatal Diseases
An anonymous reader writes "LiveScience is reporting that Tien Wong, of the Center for Eye Research Australia at the University of Melbourne, is claiming that abnormalities in the blood vessels of the retina can be used to predict diabetes, hypertension, stroke, and heart disease. These results were the culmination of several large studies. This could go a long way towards advancing medicine in the developed world as these disorders are some of the most common causes of death, hospitalization, and disability."
... and a long time lurker, now turned anonymous coward :)
Anyways, as many others have noted, this concept is really not new at all. The fact that examining the retina can clue us in to systemic disease has been around for over 100 years. The novelty here, I believe, is that the researchers have prospectively (I'm guessing from the context of the article) examined digital fundus photographs, and found that they can be used predictively in determining the risk of diabetes/hypertension etc... (essentially, diseases that preferentially affect the small vessels in the body). But even this doesn't seem that novel, I can personally recall reading an article about 5 years ago which specifically looked at examining digital photographs to screen for diabetic retinopathy.
The other interesting part of the article has to do with their work on setting up a web-based digital review center. While the idea sounds great, this type of telemedicine runs into a lot of logistical problems, a sample of which would include:
-Limited sensitivity - ocular manifestations of systemic disease are not always present, and certainly are often NOT present early in the disease course. If we give high-risk individuals a "false negative" reading, are we really enhancing their overall health?
-Medical liability - who would be reading these? A trained physician? Licensed where? I am trained in the US, and fully licensed to practice, yet I can't even cross a state border and perform an exam without breaking the law.
-How are the digital images supposed to be obtained? Digital funduscopic cameras are pretty expensive.
-Practicality -- let's see, I could either buy a digital imaging system, and submit a photo to a website for review, or I could just check this patient's blood pressure, in the office (or check a blood sugar, or cholesterol level, etc...). These tests are actually much more definitive (we check patient's blood pressures in the office, before a retinal exam!), than an eye exam.
Ideally, what would probably be more effective would be something like a software package that can automatically analyze these images (with the proper legal disclaimers, of course), bundled with a portable digital imaging system. These would be wonderful for something like large scale screenings of under-served, high-risk populations -- an indian reservation, for instance. Then, you could identify especially high risk individuals, and recommend follow-up with either an ophthalmologist or internist. Though, really, everyone should probably at least have an occasional screening physical by a real doctor (ok, ok, enough soap-boxing).