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C.J. Rudnisky, M.T. S. Tennant, M.D. J. Greve, B.J. Hinz; The rate of diabetic retinopathy in the first year of a province–wide teleophthalmology program. . Invest. Ophthalmol. Vis. Sci. 2004;45(13):4128.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: To report the rate of diabetic retinopathy and subsequent referral in the Alberta First Nation Teleophthalmology Project. Methods: Between December 2001 and December 2002, 46 teleophthalmology clinics were held within First Nations communities. Patients were elligible if they had diabetes mellitus previously diagnosed by a physician. Following informed consent and pupillary dilation, modified Airlee House retinal photographs were obtained using a high–resolution digital camera connected to a Zeiss ff450i fundus camera. Stereoscopic digital images were obtained of fields one and two, and mono photographs were obtained of fields 3 through 7. Images were graded using a modified ETDRS scale. Patients were referred for clinical examination if they were diagnosed with treatable DR, any other ocular condition requiring additional evaluation, or if they had ungradeable images. Results: A total of 996 patients were evaluated. 818 met the criteria for enrollment. 540 patients subsequently had retinal photographs taken. Of the 1080 eyes photographed, 240 (22.2%) had diabetic retinopathy. Of these eyes, 202 (84.1%) had mild or moderate NPDR. Fifteen eyes (6.3%) had severe NPDR. Twenty–six eyes (10.8%) had PDR. Eighteen of 1080 eyes (1.7%) had CSME. Only 35 eyes (3.2%) were ungradable. With respect to referrals, 101 of 540 (18.7%) patients were referred for clinical evaluation. of the referred patients, only 37 (36.6%) were for either PDR or CSME. Twenty–five (24.8%) were sent for evaluation of either cataracts or glaucoma suspects. Fifteen (14.9%) were diagnosed with other ocular conditions like retinal detachment, BRVO, CRVO, or AMD. Twenty–four (23.8%) were sent because of inadequate digital photographs. Conclusions:This larger, population based study supports previously published data on the rate of diabetic retinopathy in the diabetic First Nations population. Effective distance evaluation can reduce the number of patients required to travel for diabetic eye care, while simultaneously identifying other ocular conditions that require ophthalmologic evaluation.
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