Abstract
Abstract: :
Purpose: To describe our initial experience screening for diabetic retinopathy with telemedicine. Methods: A non-mydriatic 450 Canon CR6-45NM was set up at the Royal Victoria Hospital, McGill University. All outpatients with diabetes visiting their endocrinologist between September 2000 to January 2001 participated. Images of 830 eyes were obtained. Data collected from the patients included age, sex, type of diabetes and years of disease. Photos were sent by internet to a retinal specialist who interpreted them. Results: Only 65% of photos were considered of good quality, 35% judged to be poor for numerous reasons, mostly due to poor exposure. The technician taking the photos improved over the 4 month period (p<0.01). Hard exudates were seen in 6% of all photos. Non-proliferative diabetic retinopathy was noted in 14.1%, and proliferative in 1.8%. Unexpected findings included epiretinal membranes, macular holes, cotton wool spots and a central retinal vein occlusion. Referral to retina within one month was recommended to 10% of all patients. Conclusion: While many patients were screened efficiently, better cameras are needed in order to achieve a higher rate of readable photos. Within the readable photos, many had pathology requiring a retinal assessment, which were referred appropriately.
Keywords: 351 clinical (human) or epidemiologic studies: health care delivery/economics/manpower • 388 diabetic retinopathy • 356 clinical (human) or epidemiologic studies: systems/equipment/techniques