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T. M. McClure, K. A. Wooten, T. M. Becker, S. L. Mansberger; Proportion of Progression of Diabetic Eye Disease in Patients Monitored With a Non-Mydriatic Retinal Camera. Invest. Ophthalmol. Vis. Sci. 2010;51(13):2093.
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To determine the severity and progression of diabetic retinopathy (DR) using telemedicine and non-mydriatic cameras in an underserved, ethnically diverse diabetes clinic population.
We included data from 226 eyes of 115 patients with at least 1 follow-up imaging visit. We determined the severity of DR using a modified International Classification Scale for DR (Wilkinson, Ophthal 2003), which ranges from Stage 0 (no DR) to Stage 5 (Proliferative Diabetic Retinopathy, or PDR). We defined progression of DR as at least one stage increase from the enrollment date to last imaging date. We also determined the risk factors for DR progression.
The stage of diabetic retinopathy at last follow-up was none (n=184, 81.4%), mild nonproliferative diabetic retinopathy (NPDR) (n=23, 10.2%), moderate NPDR (n=5, 2.2%), severe NPDR (n=3, 1.3%), and PDR (n=11, 4.9%). Over an average follow-up time of 537 days, a total of 28 eyes (12.4%) had progression of DR. Ten (4.4%) eyes had a decrease in the stage of DR; 188 (83.1%) eyes did not have a change; 20 eyes (8.8%) progressed by one stage; and 8 (4.0%) progressed by 2 or more stages. The average time to progression was 500 days. In comparison to those who did not have DR progression, those with progression were older (58.0 (8.4) vs. 53.3 (11.6), p=0.01); and were more likely to have non-white ethnicity (64% vs. 46%, p<0.05). Female gender were more likely to progress (71% vs. 52%, p>0.05), but was not statistically different.
Most patients in this study did not have levels of DR requiring an intervention by an eye care provider. DR progression was more common in older and non-white participants. Telemedicine using non-mydriatic cameras can be used to follow diabetic eye disease.
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