ArticleJAMA ophthalmology2014
Telemedicine diagnosis of cytomegalovirus retinitis by nonophthalmologists.
Article in JAMA ophthalmology, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
14 citing papers in PubMed, 29 citations in OpenAlex.
- Diagnostic test accuracy of teleretinal screening for cytomegalovirus retinitis among people living with HIV: A systematic review and meta-analysis.PLOS global public health · 2026Article
- Eye on cytomegalovirus: Unveiling the ophthalmic impact of cytomegalovirus.World journal of virology · 2025Article
- The Benefits and Challenges of Implementing Teleophthalmology in Low-Resource Settings: A Systematic Review.Cureus · 2024Review
- Selection of pre-trained weights for transfer learning in automated cytomegalovirus retinitis classification.Scientific reports · 2024Article
- Deep learning system for screening AIDS-related cytomegalovirus retinitis with ultra-wide-field fundus images.Heliyon · 2024Article
- Human Immunodeficiency Virus and Uveitis.Viruses · 2023Review
- Clinical characteristics in the misdiagnosis of cytomegalovirus retinitis: A retrospective analysis of eight patients.Indian journal of ophthalmology · 2022Article
- Telemedicine in Pediatric Infectious Diseases.Children (Basel, Switzerland) · 2021Review
- The value and implementation of routine ophthalmic examination in the era of HAART.EClinicalMedicine · 2021Article
- The Current and Future Use of Telemedicine in Infectious Diseases Practice.Current infectious disease reports · 2019Review
- Cytomegalovirus retinitis and HIV: Case reviews from KwaZulu-Natal Province, South Africa.South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde · 2017Article
- Telemedicine screening for cytomegalovirus retinitis at the point of care for human immunodeficiency virus infection.JAMA ophthalmology · 2015Article
- Retinal detachment associated with AIDS-related cytomegalovirus retinitis: risk factors in a resource-limited setting.American journal of ophthalmology · 2015Article
- Ocular herpes: the pathophysiology, management and treatment of herpetic eye diseases.Virologica Sinica · 2014Review
Corrections and comments
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Authors and funding
9 authors at 6 institutions in 2 countries.
Funding
Abstract
importanceCytomegalovirus (CMV) retinitis continues to be a leading cause of blindness in many developing countries. Telemedicine holds the potential to increase the number of people screened for CMV retinitis, but it is unclear whether nonophthalmologists could be responsible for interpreting fundus photographs captured in a telemedicine program.
objectiveTo determine the accuracy of nonophthalmologist photographic graders in diagnosing CMV retinitis from digital fundus photographs. DESIGN, SETTING, AND
participantsFifteen nonexpert graders each evaluated 182 mosaic retinal images taken from the eyes of patients with AIDS who were evaluated at the Ocular Infectious Diseases Clinic at Chiang Mai University in Chiang Mai, Thailand. MAIN OUTCOMES AND MEASURES: Graders diagnosed each image as CMV retinitis present, CMV retinitis absent, or unknown. The results from each grader were compared with those of an indirect ophthalmoscopic examination from an experienced on-site ophthalmologist as well as with the consensus grade given by a panel of CMV retinitis experts.
resultsRelative to the on-site ophthalmologist, the sensitivity of remote CMV retinitis diagnosis by nonexpert graders ranged from 64.0% to 95.5% (mean, 84.1%; 95% CI, 78.6%-89.6%)), and the specificity ranged from 65.6% to 92.5% (mean, 82.3%; 95% CI, 76.6%-88.0%)). Agreement between nonexpert and expert graders was high: the mean sensitivity and specificity values of nonexpert diagnosis using expert consensus as the reference standard were 93.2% (95% CI, 90.6%-95.8%) and 88.4% (95% CI, 85.4%-91.1%), respectively. Mean intrarater reliability also was high (mean Cohen κ, 0.83; 95% CI, 0.78-0.87). CONCLUSIONS AND RELEVANCE: The sensitivity and specificity of remote diagnosis of CMV retinitis by nonexpert graders was variable, although several nonexperts achieved a level of accuracy comparable to that of CMV retinitis experts. More intensive training and periodic evaluations would be required if nonexperts are to be used in clinical practice.
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