June 2023
Volume 64, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2023
Christiana Care Health System (CCHS) Diabetic Retinopathy Screening: An Evaluation of an Ongoing Project
Author Affiliations & Notes
  • Robert Mathew Abishek
    Mid Atlantic Retina Wills Eye Hospital, Thomas Jefferson University Sidney Kimmel Medical College, Philadelphia, Pennsylvania, United States
    Ophthalmology, Christiana Care Health Services Inc, Wilmington, Delaware, United States
  • Paula Ko
    Ophthalmology, Christiana Care Health Services Inc, Wilmington, Delaware, United States
  • Tomilade Adepoju
    Ophthalmology, Christiana Care Health Services Inc, Wilmington, Delaware, United States
  • Jeffrey D Henderer
    Ophthalmology, Temple University, Philadelphia, Pennsylvania, United States
    Ophthalmology, Christiana Care Health Services Inc, Wilmington, Delaware, United States
  • Footnotes
    Commercial Relationships   Robert Abishek None; Paula Ko None; Tomilade Adepoju None; Jeffrey Henderer None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2023, Vol.64, 2273. doi:
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      Robert Mathew Abishek, Paula Ko, Tomilade Adepoju, Jeffrey D Henderer; Christiana Care Health System (CCHS) Diabetic Retinopathy Screening: An Evaluation of an Ongoing Project. Invest. Ophthalmol. Vis. Sci. 2023;64(8):2273.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : Non-mydriatic digital retinal imaging can improve patient access to diabetic retinal screening. Our previous work revealed 67% of screening images were interpretable and 13% of patients had diabetic retinopathy. The purpose of this study is to report our screening findings following three key changes: we provided additional photographer training, changed the interpreting physicians, and moved some of the cameras to different primary care offices. Outcomes of interest included time to interpretation, number of interpretable images, and the pathology identified.

Methods : Diabetic patients 18 years who participated in the Intelligent Retinal Imaging System (IRIS, Pensacola, FL) retinal screening initiative at a total of seven CCHS clinics (Wilmington, DE) from December 1, 2020, to June 30, 2022, were included. Photos were taken by clinic staff using the CenterVue DRS (Hill-Rom Holdings Inc., Chicago, IL) or Pictor Plus Fundus camera (Volk, Mentor, OH). Retinal images were primarily interpreted by a CCHS-affiliated retina specialist using the International Classification of Diabetic Retinopathy. IRIS data was used to evaluate the screening results.

Results : 762 patients (1,524 eyes) underwent the screening exam. The retina specialist interpreted 601 (79%) of the screening exams. Exams were interpreted an average of 15.1 ± 45.4 hours after photos were taken. Of the 578 patients (76%) who had bilateral interpretable images, 413 (71%) of patients had no pathology in either eye. 165 patients (29%) had a referrable diagnosis which included 78 (13%) with diabetic retinopathy (35 mild, 31 moderate, 6 severe, 6 proliferative), and a mixture of other suspected diseases such as glaucoma/glaucoma suspect (51), macular edema (29), dry AMD (21), hypertensive retinopathy (11), epiretinal membrane (3), unspecified vein occlusion (2), cataract (1), and other diseases (119).

Conclusions : Utilizing the IRIS protocol, the majority of patients were able to complete a diabetic screening. Providing additional photographer training appears to have increased the number of interpretable photographs. However, taking quality photographs remains a limitation. The fact that a retina specialist provided the majority of interpretations did not appear to change the rate of retinopathy diagnosis. A substantial number of other eye diseases were also identified. Our next steps include addressing referral and follow-up rates.

This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.

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