Diabetes Eye Screening in Urban Settings Serving Minority Populations: Detection of Diabetic Retinopathy and Other Ocular Findings Using Telemedicine
Published Date:Feb 2015
Source:JAMA Ophthalmol. 133(2):174-181.
Diagnostic Techniques, Ophthalmological
Hemoglobin A, Glycosylated
Pubmed Central ID:PMC4479273
Funding:5U58DP002651/DP/NCCDPHP CDC HHS/United States
5U58DP002652/DP/NCCDPHP CDC HHS/United States
5U58DP002653/DP/NCCDPHP CDC HHS/United States
5U58DP002655/DP/NCCDPHP CDC HHS/United States
P30 DK079626/DK/NIDDK NIH HHS/United States
U58 DP002651/DP/NCCDPHP CDC HHS/United States
U58 DP002652/DP/NCCDPHP CDC HHS/United States
U58 DP002653/DP/NCCDPHP CDC HHS/United States
U58 DP002655/DP/NCCDPHP CDC HHS/United States
The use of a non-mydriatic camera for retinal imaging combined with the remote evaluation of images at a telemedicine reading center has been advanced as a strategy for diabetic retinopathy (DR) screening, particularly among patients with diabetes from minority populations with low eye care utilization.
To examine the rate and types of DR identified through a telemedicine screening program using a non-mydriatic camera, as well as the rate of other ocular findings.
Four urban clinic or pharmacy settings in the United States serving predominantly minority and uninsured persons with diabetes.
Persons age ≥ 18 years old who have type 1 or 2 diabetes and present to the community-based settings.
Main Outcome Measure
Percentage of DR detection including type of DR, and percentage of detection of other ocular findings.
A total of 1,894 persons participated in the screening program across sites, with 21.7% having DR in at least one eye. The most common type of DR by far was background DR, which was present in 94.1% of all participants with DR. Almost half of those screened had ocular findings other than DR with 30% of other findings being cataract.
Conclusions and Relevance
In a DR telemedicine screening program in urban clinic/pharmacy settings in the US serving predominantly minority populations, 1 in 5 persons with diabetes screened positive for DR. The vast majority of DR was background indicating high public health potential for intervention in DR’s earliest phases when treatment can prevent vision loss. Other ocular conditions were detected at a high rate, a collateral benefit of DR screening programs that may be under appreciated.
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