June 2017
Volume 58, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2017
Staging of diabetic retinopathy in a sample of patients in Mexico through a reading center.
Author Affiliations & Notes
  • Hugo Valencia-Santiago
    Retina, INTITUTO MEXICANO DE OFTALMOLOGIA IAP, Queretaro, Queretaro, Mexico
  • Miguel Vazquez
    Retina, INTITUTO MEXICANO DE OFTALMOLOGIA IAP, Queretaro, Queretaro, Mexico
  • Ellery Lopez-Star
    Retina, INTITUTO MEXICANO DE OFTALMOLOGIA IAP, Queretaro, Queretaro, Mexico
  • Charles Van-Lansingh
    Retina, INTITUTO MEXICANO DE OFTALMOLOGIA IAP, Queretaro, Queretaro, Mexico
  • Veronica Romero
    Retina, INTITUTO MEXICANO DE OFTALMOLOGIA IAP, Queretaro, Queretaro, Mexico
  • Ximena Mira
    Retina, INTITUTO MEXICANO DE OFTALMOLOGIA IAP, Queretaro, Queretaro, Mexico
  • Renata Garcia Franco
    Retina, INTITUTO MEXICANO DE OFTALMOLOGIA IAP, Queretaro, Queretaro, Mexico
  • Footnotes
    Commercial Relationships   Hugo Valencia-Santiago, None; Miguel Vazquez, None; Ellery Lopez-Star, None; Charles Van-Lansingh, None; Veronica Romero, None; Ximena Mira, None; Renata Garcia Franco, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2017, Vol.58, 2904. doi:
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      Hugo Valencia-Santiago, Miguel Vazquez, Ellery Lopez-Star, Charles Van-Lansingh, Veronica Romero, Ximena Mira, Renata Garcia Franco; Staging of diabetic retinopathy in a sample of patients in Mexico through a reading center.. Invest. Ophthalmol. Vis. Sci. 2017;58(8):2904.

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

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Abstract

Purpose : 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 at rural clinics in Mexico.

Methods : This is an ongoing prospective longitudinal study. Previous informed consent was obtained from patients prior screening and assessment. A questionnaire including the ophthalmological and systemic antecedents was filled, visual acuity was performed, along with two non-mydriatic ocular fundus photographs per eye. Trained/certified readers at Singapore Eye Research Institute (SERI) read and evaluated images using the National Health Services DR grading. The intra-rater kappa coefficient for readers with respect to DR findings was 0.72 with 88.8% agreement. The inter-grader kappa coefficient for DR findings was 0.60 (95% CI 0.51-0.73) with agreement of 84.1%. Readers assigned preliminary grades within 24 hours of image upload. Ocular pathology other than DR was recorded.

Results : A total of 5628 persons participated in the screening program across sites. 4803 (85.34%) reported having DM, while 825 (14.66%) reported not having a diagnosis of DM. We evaluated 1650 eyes of patients without DM (14.66%) and 9606 eyes of patients with DM (85.34%). Of 1650 eyes of patients without DM, 1466 eyes (88.84%) were gradable and 184 eyes (11.15%) were no-gradable. Of 9606 eyes of DM patients, 7812 eyes (81.32%) were gradable and 1794 eyes (18.67%) were no-gradable. Of gradable eyes of patients with DM; 6482 eyes (82.92%) did not present RD data and 1330 eyes (17.02%) had some RD signs. 561 eyes (7.18%) presented some sign of diabetic maculopathy. Of the non-diabetic group, RD damage was identified in 15 patients (1.81%). Within the group of patients with DM, 898 (18.69%) patients had RD damage, of which 49.77% had bilateral damage. A recommendation was made for evaluation by diabetic maculopathy and diabetic retinopathy in 669 patients (13.92%) with DM.

Conclusions : The prevalence of diabetic retinopathy is high in the study population. There are undiagnosed cases of DM that can be detected through ocular fundus photography. As a technology in development, distance reading and evaluation centers have the potential to be efficient and cost-effective in providing health services to large geographic areas and unobserved populations.

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

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