July 2019
Volume 60, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2019
The Bolivian Diabetic Retinopathy (BOLDR) Project for screening and management of patients with diabetic retinopathy (DR) in underserved areas
Author Affiliations & Notes
  • Anthony C Christopher M
    Retina, Fundación Boliviana de Oftalmología, Cochabamba, Cochabamba, Bolivia, Plurinational State of
  • Rodrigo Cortes Arce
    Fundacion Boliviana de Oftalmologia, Cochabamba, Bolivia, Plurinational State of
  • Marcelo Murillo Sasamoto
    Instituto Privado de Oftalmología, Bolivia, Plurinational State of
  • Georgia Kaidonis
    Ophthalmology, University of California, San Francisco,, San Francisco, California, United States
  • Rajat N Agrawal
    Retina Global, California, United States
  • Footnotes
    Commercial Relationships   Anthony C M, None; Rodrigo Cortes Arce, None; Marcelo Murillo Sasamoto, None; Georgia Kaidonis, None; Rajat Agrawal, None
  • Footnotes
    Support  World Diabetes Foundation; Oxurion NV
Investigative Ophthalmology & Visual Science July 2019, Vol.60, 5481. doi:
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      Anthony C Christopher M, Rodrigo Cortes Arce, Marcelo Murillo Sasamoto, Georgia Kaidonis, Rajat N Agrawal; The Bolivian Diabetic Retinopathy (BOLDR) Project for screening and management of patients with diabetic retinopathy (DR) in underserved areas. Invest. Ophthalmol. Vis. Sci. 2019;60(9):5481.

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Abstract

Purpose : With minimal or non-existent retinal services in Bolivia, patients with diabetes are burdened with travelling great distances to reach retinal care. Those unable to access adequate services in a timely manner are at risk of blindness from DR. Retina Global's BOLDR project aims to build a sustainable program providing retinal services for the underserved Bolivian population.

Methods : Phase 1 of this 3-year project focuses on the city of Cochabamba in partnership with Fundacion Boliviana de Oftalmologia. As part of the project, retina specialists from the United States (US) and other countries travel to Cochabamba every 2 months to provide clinical care to patients, as well as hands - on training to local ophthalmologists in the clinic and operating room. During these visits, certification courses are organized for ophthalmologists and primary care physicians, where didactic lectures are given on DR, as well as on management of diabetes and its complications. Outreach missions are organized once every 15 days where a team visits communities in and around Cochabamba for evaluation and care. Another goal of the project is to identify ophthalmologists who will be sent to eligible programs for retinal fellowship, for them to return and provide care and train others. The project is also focused on collecting patient data (registry) to help study prevalence of DR, plan exploratory clinical trials, as well as formulate guidelines for DR management in the country.

Results : Since the commencement of the project, retina specialists from the US, Mexico and Colombia have visited Cochabamba, with more to follow on a 2 monthly basis. So far, 427 patients have been screened for DR, with 81 patients undergoing retinal laser treatment. Thirteen patients currently await vitrectomy. Seven certification courses have been conducted for ophthalmologists, as well as 5 more for primary care physicians. Nine outreach missions have been organized. So far, we have identified one ophthalmologist as a candidate for retinal fellowship training.

Conclusions : Retinal diseases such as DR are on the increase around the world, with lack of trained personnel and instrumentation in underserved areas. The intervention via this project provides clinical care to the underserved, while training ophthalmologists in retinal disease management for a long term sustainable outcome.

This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.

 

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