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Am J Ophthalmol. 2019 Mar 21. pii: S0002-9394(19)30127-8. doi: 10.1016/j.ajo.2019.03.021. [Epub ahead of print]

Telemedicine in the management of exudative age-related macular degeneration within an integrated healthcare system.

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Mayo Clinic Department of Ophthalmology, Rochester, MN.
Mayo Clinic Department of Ophthalmology, Rochester, MN. Electronic address:



To investigate the outcomes of patients with exudative age-related macular degeneration (AMD) treated with intravitreal anti-vascular endothelial growth factors (VEGF) using a telemedicine system.


Interventional case series.


We examined all patients with exudative AMD who were receiving intravitreal anti-VEGF injections from September 1st, 2015 through August 31st, 2017 using electronic consults at a single academic center and health system. Patients were managed initially by a retinal specialist and then allowed to receive further care with their local ophthalmologist. There were 200 electronic consults placed during this time period for 83 eyes of 59 patients. Data collected included the retina specialist recommendations: intravitreal agent, interval between injections, number of injections, and when the patient was to follow up. We report all occurrences when the recommendations were not completed.


The mean age of the patients at the time of e-consult was 82.3 ± 7.3 years with a mean follow up time of 2.4 ± 0.81 years. The mean distance from the home of the patient to the retina specialist was 70 ± 44 miles. There were 14 (7.1%) consults that did not comply with the recommendations of the retina specialist. The majority of these were due to other medical comorbidities leading to missed appointments or scheduling errors.


In an integrated healthcare setting, we identified 59 patients with exudative AMD that were able to be effectively managed using a telemedicine system. In the appropriate setting, telemedicine might be able to assist in the management of patients with wet AMD.


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