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Diabetes eye screening in urban settings serving minority populations: detection of diabetic retinopathy and other ocular findings using telemedicine.
JAMA Ophthalmol. 2015 Feb; 133(2):174-81.JO

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.

Authors+Show Affiliations

Department of Ophthalmology, School of Medicine, University of Alabama at Birmingham.Department of Ophthalmology, School of Medicine, University of Alabama at Birmingham2Department of Epidemiology, School of Public Health, University of Alabama at Birmingham.Department of Public Health Sciences, Miller School of Medicine, University of Miami, Miami, Florida.Bascom Palmer Eye Institute, Miller School of Medicine, University of Miami, Miami, Florida.Wilmer Eye Institute, Dana Center for Preventive Ophthalmology, The Johns Hopkins School of Medicine, Baltimore, Maryland.Wilmer Eye Institute, Dana Center for Preventive Ophthalmology, The Johns Hopkins School of Medicine, Baltimore, Maryland6Department of Epidemiology, Wake Forest School of Medicine, Winston-Salem, North Carolina7Department of Ophthalmology, Wake Forest Sc.Wills Eye Hospital, Thomas Jefferson University, Philadelphia, Pennsylvania.Wills Eye Hospital, Thomas Jefferson University, Philadelphia, Pennsylvania.Vision Health Initiative, Division of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta, Georgia.No affiliation info available

Pub Type(s)

Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

25393129

Citation

Owsley, Cynthia, et al. "Diabetes Eye Screening in Urban Settings Serving Minority Populations: Detection of Diabetic Retinopathy and Other Ocular Findings Using Telemedicine." JAMA Ophthalmology, vol. 133, no. 2, 2015, pp. 174-81.
Owsley C, McGwin G, Lee DJ, et al. Diabetes eye screening in urban settings serving minority populations: detection of diabetic retinopathy and other ocular findings using telemedicine. JAMA Ophthalmol. 2015;133(2):174-81.
Owsley, C., McGwin, G., Lee, D. J., Lam, B. L., Friedman, D. S., Gower, E. W., Haller, J. A., Hark, L. A., & Saaddine, J. (2015). Diabetes eye screening in urban settings serving minority populations: detection of diabetic retinopathy and other ocular findings using telemedicine. JAMA Ophthalmology, 133(2), 174-81. https://doi.org/10.1001/jamaophthalmol.2014.4652
Owsley C, et al. Diabetes Eye Screening in Urban Settings Serving Minority Populations: Detection of Diabetic Retinopathy and Other Ocular Findings Using Telemedicine. JAMA Ophthalmol. 2015;133(2):174-81. PubMed PMID: 25393129.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Diabetes eye screening in urban settings serving minority populations: detection of diabetic retinopathy and other ocular findings using telemedicine. AU - Owsley,Cynthia, AU - McGwin,Gerald,Jr AU - Lee,David J, AU - Lam,Byron L, AU - Friedman,David S, AU - Gower,Emily W, AU - Haller,Julia A, AU - Hark,Lisa A, AU - Saaddine,Jinan, AU - ,, PY - 2014/11/14/entrez PY - 2014/11/14/pubmed PY - 2015/4/8/medline SP - 174 EP - 81 JF - JAMA ophthalmology JO - JAMA Ophthalmol VL - 133 IS - 2 N2 - 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. SN - 2168-6173 UR - https://www.unboundmedicine.com/medline/citation/25393129/Diabetes_eye_screening_in_urban_settings_serving_minority_populations:_detection_of_diabetic_retinopathy_and_other_ocular_findings_using_telemedicine_ L2 - https://jamanetwork.com/journals/jamaophthalmology/fullarticle/10.1001/jamaophthalmol.2014.4652 DB - PRIME DP - Unbound Medicine ER -