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Dalia Méndez Marín, Renata García Franco, Van Charles Lansingh, Ellery López Star, Alejandro Arias Gómez, Paulina Ramírez Neria, Marlon García Roa, Verónica Romero Morales, Ximena Mira Lorenzo, Miguel Vazquez Membrillo, Yolanda Villalpando Gómez; Screening for diabetic retinopathy and other retinal diseases: a telemedicine project in Mexico. Invest. Ophthalmol. Vis. Sci. 2019;60(9):1101.
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© ARVO (1962-2015); The Authors (2016-present)
To determine the prevalence of diabetic retinopathy and other retinal diseases in a Mexican population through a telemedicine screening in a reading center.
Prospective, descriptive, cross-sectional study. 12201 patients were included (2016-2018). A photograph centered on macular area and the other centered on optic nerve was obtained for each eye, using a portable non-mydriatic Volk Pictor Plus® camera. The digital images were stored and sent to our image reading center: Mexican Advanced Imaging Laboratory for ocular Research (MAILOR), through a platform designed in the Mexican Institute of Ophthalmology I.A.P. The degree of diabetic retinopathy was determined according to the classification and reference criteria of the UK National Health Service (NHS) modified by the Singapore Eye Research Institute (SERI). The evaluation of the photographs was performed by trained and certified retinologists who sent a clinical recommendation through the web.
24402 eyes of 12201 patients recruited in 78 clinics and hospitals located throughout Mexico. The average age of the patients was 61.31 years (SD = 11.22, range: 18-98 years). 66.26% were women. The prevalence of diabetes mellitus (DM) was 82.75% (N= 10096) only 4.61% had follow-up with HbA1c glycated hemoglobin (7.5% +/- 1.73). 48804 fundus photographs were obtained, 83.67% of the eyes (N=21383) had graduable photographs. The prevalence of diabetic retinopathy in diabetic patients (N=20192 eyes) was 27.7% and 15.23% (N= 432) presented macular edema with compromise of the center of the fovea. The 5.05% of the eyes (N= 1233) presented age-related macular degeneration and suspicious glaucoma excavations were found in 5.27% (N= 1286). The 0.21% (N= 26) of the total of patients evaluated had clinical findings of diabetic retinopathy and they did not know until then to have DM. Other findings: epiretinal membrane in 0.18% (N=44), myelinated nerve fibers in 0.17% (N= 42), scars of toxoplasma retinochoroiditis in 0.15% (N= 36) and a case of retinal detachment with macula on.
The prevalence of diabetic retinopathy in diabetic patients was 27.7%, wich is similar to that reported in previous studies (17-30%). Telemedicine is a resource with potential growth in the near future where medical resources will be insufficient to cover the population needs, especially in developing countries.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.
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