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Christopher Tulip Shah, Ashvini Reddy, Paul Andrew Yates; The Effect of Age on Compliance with Ophthalmic Follow-up after Diabetic Retinopathy Screening. Invest. Ophthalmol. Vis. Sci. 2014;55(13):5368.
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This retrospective study investigates potential factors impacting patient compliance with the recommended initial ophthalmic follow-up examination after detection of diabetic retinopathy on tele-ophthalmic screening images.
This is a retrospective cohort study of patients who completed tele-ophthalmic screening for diabetic retinopathy at University Medical Associates (UMA), a primary care practice within the University of Virginia (UVA) Health System. A single, 45°, macula-centered image of each eye using a refurbished non-mydriatic (Topcon TRC-45N) camera with a canon DSLR-back was obtained. The images were read by a UVA ophthalmologist and graded for presence of diabetic retinopathy. Patients with evidence of diabetic retinopathy were contacted and an appointment with an ophthalmologist was scheduled at the UVA Eye Clinic. Demographic features including age, location, insurance type, gender, time from screening to referral appointment, and diabetes control (most recent hemoglobin A1c value) within each group were evaluated.
A total of 703 patients completed tele-ophthalmic screening and were subsequently scheduled an appointment with an ophthalmologist at the UVA Eye Clinic based on suspicion of diabetic retinopathy. 588 patients were compliant and completed the referral ophthalmic exam and 104 patients were not compliant and did not complete the exam. Mean age of compliant patients was 56.77 +/- 11.99 years. Mean age of non-compliant patients was 52.16 +/- 14.04 years. This difference was statistically significant (unpaired t-test, P <0.01).
Younger patients participating in diabetic retinopathy screening programs may be at an increased risk of non-compliance with completion of the recommend subsequent ophthalmic referrals. While diabetic retinopathy screening programs can offer cost-savings and reduction in visual impairment, these programs are limited by patient compliance in receiving follow-up care once pathology is identified. Additional effort may be required to encourage follow-up in younger patients.
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