Abstract
Purpose :
To evaluate risk factors for in-person follow-up compliance and diagnosis of glaucoma in patients with glaucomatous findings via teleretinal diabetic retinopathy screening (TDRS).
Methods :
Retrospective chart review was conducted on diabetic patients with large or asymmetric cup-to-disc ratios identified by teleretinal screening in Los Angeles County’s primary care-based TDRS program between 1/1/2016 to 12/31/2018. Demographic and clinical information were extracted from medical records. Risk factors for in-person visit compliance and diagnosis of glaucoma were analyzed with multivariable logistic regression in compliant patients.
Results :
837 patients with optic discs suspicious for glaucoma on teleretinal screening were included. 542 patients (64.8%) successfully completed an in-person visit with 87.6% of those diagnosed with glaucoma-related pathology (60.8% as glaucoma suspect and 26.8% as glaucoma). Patients 50-65 years old were 1.52 times as likely of being compliant with in-person visits compared to those <50 years old (p=0.048). Caucasian patients were 3.04 times as likely to be non-compliant compared to Latino patients (p=0.041). For every $10,000 increase in zip-code median income, patients were 10% less likely of being complaint (p=0.019). Those screened at sites with associated ambulatory optometry clinics were seen in-person faster than those at tertiary care medical centers, with 8% fewer days between screenings and initial in-person visits (p=0.046). Patients >65 years old were more likely to have confirmed glaucoma than those <50 years old (p <0.001). Compared to Latino patients, African American and Caucasian patients were 3.18 (p<0.001) and 7.32 times (p=0.024) as likely to have confirmed glaucoma, respectively.
Conclusions :
In this safety net patient population with suspected glaucoma on teleretinal screening, patients who were younger, Caucasian, or from higher-income neighborhoods were less likely to follow up for an in-person evaluation. Compared to Latino patients, African American patients and Caucasian patients were at higher risk for confirmed glaucoma diagnosis.
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.