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Gilberto Zamora, Javier Lozano, Richard VanNess, Sheila Nemeth, Omar Meza, Eduardo Martiñón, Elizabeth McGrew, Peter Soliz; Teleretinal Screening in Mexico: a Pilot Project as part of a Comprehensive Diabetes Care Clinic in Monterrey, México. Invest. Ophthalmol. Vis. Sci. 2013;54(15):1550.
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To conduct a proof of feasibility study for teleretinal screening services in a comprehensive diabetes care clinic in Monterrey, México.
A pilot project between VisionQuest Biomedical and Clínicas del Azúcar provides teleretinal screening services to the clinic’s patient members, who all have diabetes. Patients are imaged using a teleretinal screening system for assessment of diabetic retinopathy as part of their standard of care. The retinal camera is a Canon CR 2, 45-degree, non-mydriatic camera. The imaging protocol includes two images of the retina, one macula-centered and one optic-disc-centered, and one anterior image, for each eye. Images are uploaded automatically to a web-based PACS. Images are read according to the International Clinical Diabetic Retinopathy Grading Scale. Preliminary readings are provided by a certified ophthalmic medical technologist in Albuquerque (USA) within 48 hours. Licensed chronic disease medical doctors at Clínicas del Azúcar perform the final reading, sign off on all reports, and manage follow-up care for patients. Reports are entered into the patient’s EMR and used as part of a comprehensive diabetes care model that includes consultation with a psychologist, a nutritionist, and a chronic disease specialist, as well as diabetic foot screenings, blood work, and access to diabetes-friendly groceries. Follow up with ophthalmology for high-risk cases is arranged by the clinic.
Total number of cases: 350. Percentage of findings by DR grade: no DR (39%), Mild DR (20%), Moderate DR (21%), Moderate DR with probable CSME (3%), Severe DR (5%), PDR (4%), S/Laser PDR (8%). Other Findings: Hypertensive Retinopathy (20%)
The first phase of our pilot project demonstrates that it is feasible and effective to establish a teleretinal screening service in Mexico as part of a new model for comprehensive diabetes care unlike anything in México or others parts of the world.
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