Abstract
Purpose :
The COVID-19 pandemic prompted efforts to encourage social distancing and minimize non-urgent in-person eye care. Here, we report the outcomes of a teleophthalmology program for diabetic retinopathy screening at an integrated health system in California that was expanded during the pandemic.
Methods :
We performed a retrospective review of patients who underwent remote retinal imaging as part of a teleophthalmology program for diabetic retinopathy (DR) screening using Current Procedural Terminology (CPT) codes 92227 and 92228 at the University of California, Davis Health system between May 31st, 2019 and June 8th, 2021. Retinal images were captured at primary care locations using a Topcon NW400, Nikon RetinaStation, or Optos Primary fundus cameras, and image grading were performed by trained ophthalmologists or optometrists using a store-and-forward method. Patient records were reviewed to collect demographic, follow-up, and clinical outcomes information.
Results :
During COVID19 pandemic, the teleophthalmology program screened 570 individuals (mean age 63.2 ± 13.7). There was a significant increase in the number of patients screened per month prior to and following the COVID-19 lock-down in March 2020 (5.0 ± 3.1 patients screened per month prior to and 39.1 ± 34.8 patients per month following, P = 0.0004). Among these, 204 patients received a recommendation for in-person eye care referral, of which 127 received a referral to the UC Davis Eye Center, 85 appointments were scheduled, and 82 patients were followed in person, with a median time of 108 days between screening and in-person follow-up. Follow-up rates were generally lower during the initial months after the pandemic and increased over time. Among the patients who followed in person (mean age 63.9 ± 13.8), 10% of eyes had mild non-proliferative DR (NPDR), 5% had moderate NPDR, 3% had severe NPDR, 2% had PDR, and 4% had diabetic macular edema (DME), with similar proportions before and after the COVID-19 lockdown.
Conclusions :
Expansion of a teleophthalmology program during the COVID19 pandemic demonstrated improved DR screening rates, increased referrals, and improved follow-up for diabetic eye care at an integrated health system in Northern California.
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.