Abstract
Purpose :
The standard of care for diabetic patients is to have an eye exam, either with an eye care provider or through the use of retinal imaging. We performed a retrospective chart review to assess the use of non-mydriatic fundus imaging for diabetic retinopathy (DR) screening in the primary care setting, focusing not only on severity of DR, but also, on additional non-diabetic diagnoses.
Methods :
A retrospective chart review was performed on adults with a clinical diagnosis of type 1 or type 2 diabetes who underwent non-mydriatic digital retinal imaging during a primary care or endocrinology visit at Northwestern Medicine from November 1, 2017 to present. The Eidon SLO Confocal Scanner (Centervue Inc., Fremont, CA) was used. Images were interpreted by faculty members from Northwestern Medicine’s Department of Ophthalmology. Both the imaging report and patient medical record were used to document DR severity, non-diabetic diagnoses and degree of non-gradable images.
Results :
A total of 194 patients received retinal screening of which 188 (97%) had adequate images for interpretation. Ninety-five (25.6%) eyes were found to have some degree of diabetic retinopathy, with seventy-two (19.1%) of them being classified as mild. Sixty-one of 188 (32.5%) patients had suspected non-diabetic ocular diseases with the most common being: glaucoma suspect (11.7%) and macular degeneration suspect (10.1%). The report recommended referral for in-person eye exam in ninety-four (50%) patients undergoing retinal screening. Half of these referrals were solely for non-diabetic diagnoses.
Conclusions :
When using teleretinal screening in the primary care clinic, 25% of patients were found to have some degree of retinopathy. However, a substantial number of patients (32.5%) had non-diabetic diagnoses made. These additional non-diabetic diagnoses accounted for 50% of the referrals recommended by the screening physician.
This study shows that the use of non-mydriatic retinal imaging is not only effective in diabetic retinopathy screening, but also successful in identifying other potential non-diabetic ocular pathology.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.