June 2017
Volume 58, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2017
Telemedicine for Diabetic Retinopathy Screening for an Urban-Based Safety Net Population in Travis County, TX
Author Affiliations & Notes
  • Maria Nancy Benson
    Austin Retina Associates, Austin, Texas, United States
  • Robert Wong
    Austin Retina Associates, Austin, Texas, United States
    Department of Surgery and Perioperative Medicine, Dell Medical School, University of Texas, Austin, Texas, United States
  • Jose Augustin Martinez
    Austin Retina Associates, Austin, Texas, United States
    Department of Surgery and Perioperative Medicine, Dell Medical School, University of Texas, Austin, Texas, United States
  • Stephanie Collins
    Austin Retina Associates, Austin, Texas, United States
  • Mark S Hernandez
    Internal Medicine , Dell Medical School , Austin, Texas, United States
  • Clio Armitage Harper
    Austin Retina Associates, Austin, Texas, United States
    Department of Surgery and Perioperative Medicine, Dell Medical School, University of Texas, Austin, Texas, United States
  • James W Dooner
    Austin Retina Associates, Austin, Texas, United States
    Department of Surgery and Perioperative Medicine, Dell Medical School, University of Texas, Austin, Texas, United States
  • Mark Levitan
    Austin Retina Associates, Austin, Texas, United States
    Department of Surgery and Perioperative Medicine, Dell Medical School, University of Texas, Austin, Texas, United States
  • Peter A Nixon
    Austin Retina Associates, Austin, Texas, United States
    Department of Surgery and Perioperative Medicine, Dell Medical School, University of Texas, Austin, Texas, United States
  • Shelley Day-Ghafoori
    Austin Retina Associates, Austin, Texas, United States
    Department of Surgery and Perioperative Medicine, Dell Medical School, University of Texas, Austin, Texas, United States
  • Ryan C Young
    Austin Retina Associates, Austin, Texas, United States
    Department of Surgery and Perioperative Medicine, Dell Medical School, University of Texas, Austin, Texas, United States
  • Footnotes
    Commercial Relationships   Maria Benson, None; Robert Wong, Intelligent Retinal Imaging Systems (R); Jose Martinez, Intelligent Retinal Imaging Systems (R); Stephanie Collins, None; Mark Hernandez, None; Clio Harper, Intelligent Retinal Imaging Systems (R); James Dooner, Intelligent Retinal Imaging Systems (R); Mark Levitan, Intelligent Retinal Imaging Systems (R); Peter Nixon, Intelligent Retinal Imaging Systems (R); Shelley Day-Ghafoori, Intelligent Retinal Imaging Systems (R); Ryan Young, Intelligent Retinal Imaging Systems (R)
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2017, Vol.58, 2902. doi:
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    • Get Citation

      Maria Nancy Benson, Robert Wong, Jose Augustin Martinez, Stephanie Collins, Mark S Hernandez, Clio Armitage Harper, James W Dooner, Mark Levitan, Peter A Nixon, Shelley Day-Ghafoori, Ryan C Young; Telemedicine for Diabetic Retinopathy Screening for an Urban-Based Safety Net Population in Travis County, TX. Invest. Ophthalmol. Vis. Sci. 2017;58(8):2902.

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

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Abstract

Purpose : Diabetic patients who are uninsured, underinsured or are low-income residents may have additional barriers towards recommended ophthalmological screening visits. This study examines the impact of teleretinal screening on this population who are covered by a government funded safety net health program in central Texas.

Methods : Retinal images were taken in the two different primary care physician’s (PCP) offices and uploaded to the cloud-based Intelligent Retinal Imaging System (IRIS). Patient data was accessed from IRIS over a 7-month period (April to October 2016). Demographic information included age, gender, and PCP location. The total number of patients screened, any ocular pathology, diabetic retinopathy, the severity of DR and presence of diabetic macular edema (DME) was recorded. Those in need of further care were contacted by the reading center to schedule appointments. The capture rate, defined as the number of patients requiring urgent referral who attended their appointment, was calculated.

Results : 1830 patients were screened. Severity of DR and presence of DME in both clinics is shown in Figure 1. Overall period prevalence of DR was 26.6% (486/1830). Prevalence of DR was significantly higher in the south location at 28.9% as compared to the north location at 24.0% (p<0.05). Prevalence of DME was also significantly higher in the south location as compared to north (10.1% vs 6.9%; p < 0.05). Screening identified 272 patients requiring referral to an ophthalmologist or 14.9% (272/1830). 1558 patients (85.1%) did not need further examination until their next scheduled image. Overall capture rate was 65.4% (178/272). 91 of the remaining 94 either declined, already had an eye doctor, or were unable to be contacted.

Conclusions : For uninsured, underinsured, and low-income patients obtaining healthcare within a government funded safety net healthcare system, teleretinal diabetic screening can be an effective means of screening for ocular disease. Strategic placement of cameras may help identify where diabetic disease is more prevalent. Direct contact from the reading center to these patients immediately following identification of pathology is a likely contributing factor to increasing patient capture rate of this at-risk population.

This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.

 

 

Location of Teleretinal Imaging Cameras within Central Texas

Location of Teleretinal Imaging Cameras within Central Texas

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