Abstract
Purpose :
To examine the rate and types of DR identified through a telemedicine screening program using a non-mydriatic camera, as well as the rate of other ocular findings at rural clinics in Mexico.
Methods :
This is an ongoing prospective longitudinal study. Previous informed consent was obtained from patients prior screening and assessment. A questionnaire including the ophthalmological and systemic antecedents was filled, visual acuity was performed, along with two non-mydriatic ocular fundus photographs per eye. Trained/certified readers at Singapore Eye Research Institute (SERI) read and evaluated images using the National Health Services DR grading. The intra-rater kappa coefficient for readers with respect to DR findings was 0.72 with 88.8% agreement. The inter-grader kappa coefficient for DR findings was 0.60 (95% CI 0.51-0.73) with agreement of 84.1%. Readers assigned preliminary grades within 24 hours of image upload. Ocular pathology other than DR was recorded.
Results :
A total of 5628 persons participated in the screening program across sites. 4803 (85.34%) reported having DM, while 825 (14.66%) reported not having a diagnosis of DM. We evaluated 1650 eyes of patients without DM (14.66%) and 9606 eyes of patients with DM (85.34%). Of 1650 eyes of patients without DM, 1466 eyes (88.84%) were gradable and 184 eyes (11.15%) were no-gradable. Of 9606 eyes of DM patients, 7812 eyes (81.32%) were gradable and 1794 eyes (18.67%) were no-gradable. Of gradable eyes of patients with DM; 6482 eyes (82.92%) did not present RD data and 1330 eyes (17.02%) had some RD signs. 561 eyes (7.18%) presented some sign of diabetic maculopathy. Of the non-diabetic group, RD damage was identified in 15 patients (1.81%). Within the group of patients with DM, 898 (18.69%) patients had RD damage, of which 49.77% had bilateral damage. A recommendation was made for evaluation by diabetic maculopathy and diabetic retinopathy in 669 patients (13.92%) with DM.
Conclusions :
The prevalence of diabetic retinopathy is high in the study population. There are undiagnosed cases of DM that can be detected through ocular fundus photography. As a technology in development, distance reading and evaluation centers have the potential to be efficient and cost-effective in providing health services to large geographic areas and unobserved populations.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.