September 2016
Volume 57, Issue 12
Open Access
ARVO Annual Meeting Abstract  |   September 2016
A retrospective, observational analysis of the impact of a telemedicine system to identify ocular disease in patients with diabetes mellitus screened in a non-eye care medical setting
Author Affiliations & Notes
  • Ingrid E Zimmer-Galler
    Clinical-Retina, Johns Hopkins Medical Institutions, Baltimore, Maryland, United States
  • Yvonne Chu
    Baylor College of Medicine, Houston, Texas, United States
  • Christina Y. Weng
    Baylor College of Medicine, Houston, Texas, United States
  • Jose A Martinez
    Austin Retina, Austin, Texas, United States
  • sunil gupta
    Retinal Specialty Institute, Pensacola, Florida, United States
  • Footnotes
    Commercial Relationships   Ingrid Zimmer-Galler, Johns Hopkins Medical Institutions (E); Yvonne Chu, Baylor College of Medicine (E); Christina Weng, Baylor College of Medicine (E); Jose Martinez, Intelligent Retinal Imaging Systems (C); sunil gupta, Alcon (C), Allergan (C), Genetech (C), Intelligent Retinal Imaging Systems (I), Intelligent Retinal Imaging Systems (P), Regeneron (C), USRetina (I)
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science September 2016, Vol.57, 3400. doi:
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      Ingrid E Zimmer-Galler, Yvonne Chu, Christina Y. Weng, Jose A Martinez, sunil gupta; A retrospective, observational analysis of the impact of a telemedicine system to identify ocular disease in patients with diabetes mellitus screened in a non-eye care medical setting. Invest. Ophthalmol. Vis. Sci. 2016;57(12):3400.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : Currently, less than 50% of patients diagnosed with diabetes mellitus conform to the recommendation to undergo an annual retinal evaluation to detect diabetes-related eye complications. This retrospective, observational analysis was designed to better understand the impact of a telemedicine screening system implemented in non-eye care medical facilities to provide evaluations for diabetic retinopathy.

Methods : A total of 59,347 patients with a prior diagnosis of diabetes were screened in primary care health settings over a 36 month period utilizing a commercially available telemedicine system. The system includes an automated non-mydriatic fundus camera, telemedicine platform, centralized reading center and grading platform and a secure Internet-based data transfer portal. The images were reviewed at the reading center and a report with the findings and recommendations for referral were returned to the primary care physician.

Results : Of the imaged patients, 34,709 (58.5%) were noted to have ocular pathology of which 23,803 (40.1%) and 7,146 (12.1%) respectively had mild nonproliferative diabetic retinopathy and moderate nonproliferative diabetic retinopathy to proliferative diabetic retinopathy that was previously undetected. Additionally, other major ocular pathology that was detected included: suspected glaucoma (4,550, 7.7%), suspected cataract (1,279, 2.2%), macular edema (5,517, 9.3%), suspected hypertensive retinopathy (3,443, 5.8%), and suspected age-related macular degeneration (1,372, 2.3%).

Conclusions : Telemedicine platforms can provide first line screening for diabetic retinopathy in a non-eye care medical setting. A large number of patients can be screened in a cost-effective manner. Other ocular pathology can also be detected in patients being evaluated for diabetic retinopathy. This telemedicine system has demonstrated an ability to increase patient compliance with well-established recommendations for eye examinations in patients with diabetes. Timely identification of advanced diabetic retinopathy will allow appropriate referral and treatment with the ultimate goal of reducing vision loss from diabetes.

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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