Diabetes eye screening in urban settings serving minority populations: detection of diabetic retinopathy and other ocular findings using telemedicine.

Authors

Cynthia Owsley, Department of Ophthalmology, School of Medicine, University of Alabama at Birmingham
Gerald McGwin, Department of Ophthalmology, School of Medicine, University of Alabama at Birmingham; Department of Epidemiology, School of Public Health, University of Alabama at Birmingham
David J Lee, Department of Public Health Sciences, University of Miami Miller School of Medicine
Byron L Lam, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine
David S Friedman, Dana Center for Preventive Ophthalmology, Wilmer Eye Institute, Johns Hopkins School of MedicineFollow
Emily W Gower, Dana Center for Preventive Ophthalmology, Wilmer Eye Institute, Johns Hopkins School of Medicine; Departments of Epidemiology and Ophthalmology, Wake Forest School of Medicine
Julia A Haller, Wills Eye Hospital, Thomas Jefferson UniversityFollow
Lisa A Hark, Wills Eye Hospital, Thomas Jefferson UniversityFollow
Jinan Saaddine, Vision Health Initiative, Division of Diabetes Translation, Centers for Disease Control and Prevention

Document Type

Article

Publication Date

2-1-2015

Comments

This article has been peer reviewed. It was published in: JAMA Ophthalmology.

Volume 133, Issue 2, 1 February 2015, Pages 174-181.

The published version is available at DOI: 10.1001/jamaophthalmol.2014.4652

Copyright © 2015 American Medical Association. All rights reserved.

Abstract

IMPORTANCE: The use of a nonmydriatic camera for retinal imaging combined with the remote evaluation of images at a telemedicine reading center has been advanced as a strategy for diabetic retinopathy (DR) screening, particularly among patients with diabetes mellitus from ethnic/racial minority populations with low utilization of eye care.

OBJECTIVE: To examine the rate and types of DR identified through a telemedicine screening program using a nonmydriatic camera, as well as the rate of other ocular findings.

DESIGN, SETTING, AND PARTICIPANTS: A cross-sectional study (Innovative Network for Sight [INSIGHT]) was conducted at 4 urban clinic or pharmacy settings in the United States serving predominantly ethnic/racial minority and uninsured persons with diabetes. Participants included persons aged 18 years or older who had type 1 or 2 diabetes mellitus and presented to the community-based settings.

MAIN OUTCOMES AND MEASURES: The percentage of DR detection, including type of DR, and the percentage of detection of other ocular findings.

RESULTS: A total of 1894 persons participated in the INSIGHT screening program across sites, with 21.7% having DR in at least 1 eye. The most common type of DR was background DR, which was present in 94.1% of all participants with DR. Almost half (44.2%) of the sample screened had ocular findings other than DR; 30.7% of the other ocular findings were cataract.

CONCLUSIONS AND RELEVANCE: In a DR telemedicine screening program in urban clinic or pharmacy settings in the United States serving predominantly ethnic/racial minority populations, DR was identified on screening in approximately 1 in 5 persons with diabetes. The vast majority of DR was background, indicating high public health potential for intervention in the earliest phases of DR when treatment can prevent vision loss. Other ocular conditions were detected at a high rate, a collateral benefit of DR screening programs that may be underappreciated.

Recommended Citation

Owsley, Cynthia; McGwin, Gerald; Lee, David J; Lam, Byron L; Friedman, David S; Gower, Emily W; Haller, Julia A; Hark, Lisa A; and Saaddine, Jinan, "Diabetes eye screening in urban settings serving minority populations: detection of diabetic retinopathy and other ocular findings using telemedicine." (2015). Wills Eye Hospital Papers. Paper 53.
https://jdc.jefferson.edu/willsfp/53

PubMed ID

25393129