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Sean Michael Rodriguez, Eric B. Hamill, Nabeel Moon, Amritha Kanakamedala, Christina Y. Weng; Comparing Teleretinal Screening-Identified Diabetic Retinopathy with Diabetic Nephropathy and Other Markers of Systemic Disease. Invest. Ophthalmol. Vis. Sci. 2018;59(9):1044.
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© ARVO (1962-2015); The Authors (2016-present)
To compare the ophthalmic results of a diabetic retinopathy teleretinal (TRI) screening program in a large, urban, ethnic minority-predominant population with underlying systemic markers of disease.
Retrospective cohort analysis evaluating patients screened through the Harris Health System (HHS, Houston, TX) TRI program June 2013-December 2014. Patients’ teleretinal images were cross-referenced with the electronic medical record from HHS hospitals and clinics. Demographics, systemic comorbidities, and underlying markers of disease were collected for all patients. Student’s t-test was used for statistical analysis.
903 patients met inclusion criteria, of which 58.5% were Hispanic, 21.8% Black, 11.0 % Asian, and 8.1% Caucasian. The prevalence of any diabetic retinopathy (DR) was 28.3% and any diabetic nephropathy (DN) was 37.5%. For patients with any DR, mean hemoglobin A1c (HbA1c) was 9.2%; median values for BUN (blood urea nitrogen), Cr (creatinine), microalbuminuria, and SBP (systolic blood pressure) were 16.0, 0.8, 40.5, and 134, respectively. For patients with any DN, mean HbA1c was 8.9%; median values for BUN, Cr, BMI (body mass index), and SBP were 15.0, 0.8, 30.7, and 135, respectively. HbA1c, BUN, Cr, BUN/Cr, microalbuminuria, BMI, and SBP were significantly greater in patients with any degree of retinopathy compared with those without retinopathy (p < 0.05). HbA1c, BUN, Cr, TG (triglyceride), SBP, and DBP (diastolic blood pressure) were significantly greater in patients with any degree of DN compared to those without (p < 0.05). No statistically significant differences in TG, HDL (high-density lipoprotein), or LDL (low-density lipoprotein) were observed between patients with DR vs. no DR; no statistically significant differences in HDL and LDL were observed between those with DN vs. no DN.
Results of this community-based TRI screening study confirms a similar distribution of DR and DN prevalence to that shown in other studies that are based on in-clinic examinations of similar populations. Higher levels of HbA1c, BUN, Cr, and blood pressure appear to be associated with higher degrees of both DR and DN; therefore, patients with abnormal levels of these measures may carry a worse ophthalmic or nephropathic prognosis and benefit from more vigilant surveillance.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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