Purpose
Clinics may use telemedicine to screen for diabetic retinopathy in diabetic patients. We were interested in the prevalence of other eye diseases.
Methods
We recruited diabetic patients 18 or older who have difficulty acquiring annual diabetic retinopathy screening examinations from Yellowhawk Tribal Health Center (Pendleton, OR) and Hunter Health Clinic (Wichita, KS). We randomly assigned the edparticipants to either the telemedicine or traditional surveillance group. We determined the prevalence of early age-related macular degeneration (ARMD, defined as having soft drusen > 125 microns, or drusen with pigmentary changes without late ARMD, not caused by any other disorder) and late ARMD (defined as having macular fluid, geographic atrophy, or neovascular maculopathy within the macula, not caused by any other disorder), glaucomatous features (defined as having rim thinning, nerve fiber defect, or excavation) , macular edema (defined as having retinal thickening within 500 lm of the fovea, exudates associated with retina thickening within 500 lm of the fovea, or retinal thickening of one disc diameter in size within one disc diameter of the fovea), and other disease. We used both eyes of a participant to determine ocular burden of disease, as we were interested in the prevelance of the eye disease in either diabetic eye.
Results
We included 820 eyes from 460 patients for analysis. While 598/820 (72.9%) eyes had normal eye images, 195/820 (23.8%) eyes had one disease identified, 20/820 (2.4%) had two diseases identified simultaneously, and 7/820 (0.85%) eyes had three diseases identified simultaneously. The most common ocular diseases included diabetic retinopathy (143/820, 17.4%), glaucomatous features (56/820, 6.83%), dry ARMD (31/820, 3.8%), and macular edema (5/820, 0.61%). Other less frequent diseases included epiretinal membrane, and choroidal/retinal lesion such as nevi.
Conclusions
Most diabetic patients do not have visually significant eye disease requiring a subsequent visit with an ophthalmologist. However, diabetic patients may have other eye diseases such as glaucoma and macular degeneration, which require eye care provider follow-up.