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Nika Bagheri, Laura Pizzi, Benjamin Leiby, Ann P Murchison; Eye Care as a Critical Component of Dialysis Patients' Medical Home. Invest. Ophthalmol. Vis. Sci. 2016;57(12):1578.
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© ARVO (1962-2015); The Authors (2016-present)
Over 40% of dialysis patients have diabetes, yet only 25% of these patients get annual eye exams. This study evaluates the need for improved access to eye care and prevalence of diabetic retinopathy (DR) in two populations of diabetic patients on hemodialysis.
This is a prospective, cross sectional, IRB approved study at both an urban and suburban dialysis center. A survey (including eye care utilization and visual functioning), visual acuity, and non-mydriatic fundus photos are performed. Medical records are used to extract other variables.
29 patients (47%) at the suburban site have been screened and 33 patients (53%) at the urban site have been screened. The average age of the patients was 63.7 (SD=13.5) with 55% male and 45% female patients. 59% of patients identified as African American and 36% identified as Caucasian. Over 66% of patients did not prioritize annual eye exams despite both knowing of the risk of DR and having their primary care doctor’s recommendation. 69% of patients received at least an annual podiatry exam. Over 50% of images were interpretable. 42% of the suburban site patients and 47% of the suburban site patients had DR. Including unreadable images, only 4 patients need to be screened to detect a case of DR. Other eye pathology including cataracts (33%) and glaucoma suspects (20%) were also identified, although data was limited by readable image quality.
There is a high need for ophthalmic care in this population. Tele-ophthalmology provides a feasible means to screen high-risk patients for DR at hemodialysis centers. Making dialysis centers the medical home for patients may lower screening barriers and improve ophthalmic outcomes.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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