Ocular telemedicine can deliver eye care to millions of Americans who do not have access to services. This K23 proposal demonstrates Dr. Maria A. Woodward's commitment to research that addresses a national and global public health care need and her commitment to the pursuit of investigator independence. Although posterior eye diseases cause the majority of visual impairment in the United States, the National Eye Institute's (NEI) strategic plan states that anterior eye diseases result in the majority of visitsto eye care professionals nationally and cause blindness in millions globally. The NEI plan also emphasizes the significant need for research that can establish the safety, reliability and feasibility of telemedicine procedures through pilot studies and determine which ophthalmic applications are amenable to telemedicine, while still preserving the accuracy, sensitivity and specificity achieved with in-person examinations. Although funded research projects have established fundus photography for remote assessment of diabetic retinopathy, no pilot projects have focused on the external and anterior eye. Dr. Woodward's career public health goal is to extend affordable and accessible eye care to underserved communities in order to detect eye conditions earlier in their course. Her career research goal is to test applications of ophthalmic technology that are amenable to telemedicine. The immediate project goals are two-fold. First, the applicant seeks to develop rigorous and accurate methods for detecting key external and anterior eye diseases using external photography. The applicant will conduct pilot studies testing external photography protocols on subjects with known anterior eye diseases. Second, the applicant seeks to validate a vision questionnaire that will augment comprehensive telemedicine assessments to determine eye health and whether or not anterior eye diseases are present. The applicant will administer multiple pre-validated vision questionnaires (e.g., the National Eye Institute Visual Function Questionnaire) and correlate answers with clinical examination findings. Dr. Woodward's research is supported by training goals that will provide the foundation for her to develop into an independent investigator. The applicant will utilize the immense resources at the University of Michigan and the support of research mentors, including Drs. Paul Lee and David Musch, to accomplish three specific training aims: 1) expertise in research methodology, 2) excellence in telemedicine programmatic development, and 3) refined knowledge of ophthalmic imaging. Dr. Woodward has set forth a plan for targeted coursework, individualized mentorship, and directed self-study to assure achieving these aims. In the process, she will obtain a master's degree in health and health care research from the Robert Wood Johnson Foundation Clinical Scholars Program.

Public Health Relevance

This project aims to provide new clinical guideposts for remote eye care - a promising solution to the challenge of providing care for the millions of Americans with inadequate access to services. The research evaluates two new key components for comprehensive telemedicine eye disease assessment: (1) protocols for external photography for anterior eye diseases and (2) a comprehensive vision questionnaire. The goal is to grow ocular telemedicine programs across the country to help patients and doctors in underserved communities.

Agency
National Institute of Health (NIH)
Institute
National Eye Institute (NEI)
Type
Mentored Patient-Oriented Research Career Development Award (K23)
Project #
5K23EY023596-03
Application #
8916745
Study Section
Special Emphasis Panel (ZEY1)
Program Officer
Agarwal, Neeraj
Project Start
2013-09-30
Project End
2016-08-31
Budget Start
2015-09-01
Budget End
2016-08-31
Support Year
3
Fiscal Year
2015
Total Cost
Indirect Cost
Name
University of Michigan Ann Arbor
Department
Ophthalmology
Type
Schools of Medicine
DUNS #
073133571
City
Ann Arbor
State
MI
Country
United States
Zip Code
48109
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Newman-Casey, Paula Anne; Woodward, Maria A; Niziol, Leslie M et al. (2018) Brand Medications and Medicare Part D: How Eye Care Providers' Prescribing Patterns Influence Costs. Ophthalmology 125:332-339
Woodward, Maria A; Valikodath, Nita G; Newman-Casey, Paula Anne et al. (2018) Eye Symptom Questionnaire to Evaluate Anterior Eye Health. Eye Contact Lens 44:384-389
Vijayakumar, Nithya P; Parikh, Purak; Mian, Shahzad I et al. (2018) Donor cornea tissue in cases of drowning or water submersion: eye banks practice patterns and tissue outcomes. Cell Tissue Bank 19:1-8
Shah, Ankoor R; Yonekawa, Yoshihiro; Todorich, Bozho et al. (2017) Prediction of Anti-VEGF Response in Diabetic Macular Edema After 1 Injection. J Vitreoretin Dis 1:169-174
Todorich, Bozho; Thanos, Aristomenis; Yonekawa, Yoshihiro et al. (2017) Simultaneous dexamethasone intravitreal implant and anti-VEGF therapy for neovascular age-related macular degeneration resistant to anti-VEGF monotherapy. J Vitreoretin Dis 1:65-74

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