Abstract
Purpose :
To characterize the demographic and clinical factors that are associated with severities of diabetic retinopathy (DR) at the teleretinal screening encounter at the Veterans Affairs (VA) health care system.
Methods :
This is a retrospective study of the DR teleretinal screening data from the VA VISN 20 network (northwestern US states) from 2006-2017. A total of 11,941 unique patient screening encounters were identified in the VA national Corporate Data Warehouse (CDW) along with the following demographic and clinical factors: age, gender, race, and the HgbA1c and estimated glomerular filtration rate (eGFR) within 6 months of screening encounter. The encounters that resulted in poor-quality imaging were excluded from analyses. Categorical and continuous variables were analyzed by Fisher’s exact test and ANOVA, respectively.
Results :
Overall, 82.3% had no disease, 13.3% had mild DR, 3.2% had moderate DR, 0.8% had severe DR, and 0.3% had proliferative diabetic retinopathy at the baseline teleretinal DR screening encounter. 11.0% of the total number of images were of poor quality. Compared to Caucasians, all other races (Native Americans, African Americans, Asians) had higher prevalence of DR and more severe stages of retinopathy at the baseline screening visit. African Americans had the highest rate of poor-quality images. There was a negative correlation between age and DR severity. Higher HgbA1c (Figure A) and lower eGFR (Figure B) were significantly associated with higher DR severity (p-value < 0.001). The distribution of ethnic demographics and DR severity were both significantly different over the 10-year period (p-values < 0.001).
Conclusions :
Higher HgbA1c and lower eGFR are significantly associated with higher DR severity at baseline teleretinal screening visit. The overall distribution of racial ethnicities and baseline DR severities in the veteran teleretinal program has changed over the 10-year period.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.