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Richard VanNess, Gilberto Zamora, Sheila Nemeth, Elizabeth McGrew, Wendall Bauman, Son Nguyen, Peter Soliz; Ocular Conditions of Diabetics and Non-Diabetics in a Primary Care Setting. Invest. Ophthalmol. Vis. Sci. 2013;54(15):1553. doi: https://doi.org/.
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To present results of eye disease findings by a teleretinal evaluation project in a primary care setting in South Texas. Ultimately, the goal is to implement computer-based retinal screening.
VisionQuest Biomedical and CommuniCare Health Centers formed an alliance to provide the first teleretinal evaluation service as part of a research study to build a database of cases in a primarily Hispanic populated region and to provide diabetic retinal screening to underserved populations in South Texas (TX). Patients were referred for retinal screening by their primary care physician at Communicare, and images were acquired on-site after their regular examination, or by appointment at a later date. VisionQuest applied an imaging protocol that uses a 45-degree non-mydriatic camera to acquire three color images of each eye, two fundus images (macula-centered and optic disc-centered), and an anterior image. Cases were graded online by a network of licensed optometrists and ophthalmologists .
Table 1 breaks down the data into diabetic and non-diabetic groups, and presents the number of individuals with and without findings. Over half of the diabetics had some findings, twice the level of eye disease as the non-diabetic population. Nevertheless, nearly one in four non-diabetics were was found to have some form of eye disease. Table 2 breaks down the findings subgroup into four classes: diabetic retinopathy (DR), hypertensive retinopathy (HTN), cataracts, and drusen. While the focus of the screening had been on diabetic retinopathy (24.6% of diabetics), risk factors for chronic hypertension were found in nearly 19.1% of the diabetics and 10% of the non-diabetics. Of the undiagnosed diabetics, 3.2% presented with retinopathy. The percentage of unreadable cases was 4.5%.
A wide spectrum of ocular diseases other than diabetic retinopathy was found through retinal screening. Implementing a routine eye screening for retinopathy in a primary care setting offers the opportunity to detect ocular diseases as well as other health complications such as hypertension.
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