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Use of Telehealth Screening to Detect Diabetic Retinopathy and Other Ocular Findings in Primary Care Settings.
Telemed J E Health. 2019 09; 25(9):802-807.TJ

Abstract

Purpose:

To determine the incidence of diabetic retinopathy (DR) and other ocular findings in previously diagnosed diabetes using telehealth retinal screening with nonmydriatic fundus photography (nFP) in primary care physicians' offices.

Methods:

A retrospective study based on electronic chart review was performed. All diabetic patients who participated in the Wills Eye Hospital (WEH) telehealth retinal screening program from July 1, 2012 to February 20, 2017 were included. In addition to evaluation of DR, other eye pathologies of the retina were detected using nFP.

Results:

Overall, 9,946 diabetics participated in the WEH telehealth screening system. After exclusion of missing or unreadable images, 15,180 eyes of 7,624 (76.7%) patients were eligible for final analysis. A total of 1,269 (16.6%) patients were noted to have DR changes in at least one eye. Of those, 475 (37.4%) had mild nonproliferative DR (NPDR) in the more severely affected eye, 712 (56.1%) had moderate NPDR, 33 (2.6%) had severe NPDR, 19 (1.5%) had proliferative DR, and 30 (2.4%) have received pan-retinal photocoagulation previously. In addition, there was evidence of diabetic macular edema detectable on nFP in 34 eyes of 29 patients. Other ocular findings included hypertensive retinopathy (709, 9.3%), increased or asymmetric cup-to-disc ratio (562, 7.4%), age-related cataract (379, 5.0%), cotton-wool spots (221, 2.9%), choroidal nevus (74, 1.0%), age-related macular degeneration (AMD) (66, 0.9%), and epiretinal membrane (48, 0.6%). Patients with hypertensive retinopathy, glaucomatous findings, cataract, or AMD were significantly older (p < 0.001) than those without these ocular pathologies.

Conclusion:

The WEH Telehealth Screening Program identified DR in approximately one out of six patients and other ocular pathologies in over 25% of the diabetic population that received screenings in Philadelphia area primary care offices. Given the importance of early detection and routine eye care to prevent vision loss for DR patients, these findings have a significant impact.

Authors+Show Affiliations

Wills Eye Hospital, Thomas Jefferson University, Philadelphia, Pennsylvania. Beijing Anzhen Hospital, Capital Medical University, Beijing, China.Wills Eye Hospital, Thomas Jefferson University, Philadelphia, Pennsylvania.Wills Eye Hospital, Thomas Jefferson University, Philadelphia, Pennsylvania.Wills Eye Hospital, Thomas Jefferson University, Philadelphia, Pennsylvania.Wills Eye Hospital, Thomas Jefferson University, Philadelphia, Pennsylvania.Wills Eye Hospital, Thomas Jefferson University, Philadelphia, Pennsylvania.Wills Eye Hospital, Thomas Jefferson University, Philadelphia, Pennsylvania.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

30481134

Citation

Gao, Xinxiao, et al. "Use of Telehealth Screening to Detect Diabetic Retinopathy and Other Ocular Findings in Primary Care Settings." Telemedicine Journal and E-health : the Official Journal of the American Telemedicine Association, vol. 25, no. 9, 2019, pp. 802-807.
Gao X, Park CH, Dedrick K, et al. Use of Telehealth Screening to Detect Diabetic Retinopathy and Other Ocular Findings in Primary Care Settings. Telemed J E Health. 2019;25(9):802-807.
Gao, X., Park, C. H., Dedrick, K., Borkar, D. S., Obeid, A., Reber, S., & Federman, J. (2019). Use of Telehealth Screening to Detect Diabetic Retinopathy and Other Ocular Findings in Primary Care Settings. Telemedicine Journal and E-health : the Official Journal of the American Telemedicine Association, 25(9), 802-807. https://doi.org/10.1089/tmj.2018.0016
Gao X, et al. Use of Telehealth Screening to Detect Diabetic Retinopathy and Other Ocular Findings in Primary Care Settings. Telemed J E Health. 2019;25(9):802-807. PubMed PMID: 30481134.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Use of Telehealth Screening to Detect Diabetic Retinopathy and Other Ocular Findings in Primary Care Settings. AU - Gao,Xinxiao, AU - Park,Carl H, AU - Dedrick,Krista, AU - Borkar,Durga S, AU - Obeid,Anthony, AU - Reber,Shae, AU - Federman,Jay, Y1 - 2018/11/27/ PY - 2018/11/28/pubmed PY - 2020/9/25/medline PY - 2018/11/28/entrez KW - diabetic retinopathy KW - ocular pathology KW - screening KW - telehealth SP - 802 EP - 807 JF - Telemedicine journal and e-health : the official journal of the American Telemedicine Association JO - Telemed J E Health VL - 25 IS - 9 N2 - Purpose: To determine the incidence of diabetic retinopathy (DR) and other ocular findings in previously diagnosed diabetes using telehealth retinal screening with nonmydriatic fundus photography (nFP) in primary care physicians' offices. Methods: A retrospective study based on electronic chart review was performed. All diabetic patients who participated in the Wills Eye Hospital (WEH) telehealth retinal screening program from July 1, 2012 to February 20, 2017 were included. In addition to evaluation of DR, other eye pathologies of the retina were detected using nFP. Results: Overall, 9,946 diabetics participated in the WEH telehealth screening system. After exclusion of missing or unreadable images, 15,180 eyes of 7,624 (76.7%) patients were eligible for final analysis. A total of 1,269 (16.6%) patients were noted to have DR changes in at least one eye. Of those, 475 (37.4%) had mild nonproliferative DR (NPDR) in the more severely affected eye, 712 (56.1%) had moderate NPDR, 33 (2.6%) had severe NPDR, 19 (1.5%) had proliferative DR, and 30 (2.4%) have received pan-retinal photocoagulation previously. In addition, there was evidence of diabetic macular edema detectable on nFP in 34 eyes of 29 patients. Other ocular findings included hypertensive retinopathy (709, 9.3%), increased or asymmetric cup-to-disc ratio (562, 7.4%), age-related cataract (379, 5.0%), cotton-wool spots (221, 2.9%), choroidal nevus (74, 1.0%), age-related macular degeneration (AMD) (66, 0.9%), and epiretinal membrane (48, 0.6%). Patients with hypertensive retinopathy, glaucomatous findings, cataract, or AMD were significantly older (p < 0.001) than those without these ocular pathologies. Conclusion: The WEH Telehealth Screening Program identified DR in approximately one out of six patients and other ocular pathologies in over 25% of the diabetic population that received screenings in Philadelphia area primary care offices. Given the importance of early detection and routine eye care to prevent vision loss for DR patients, these findings have a significant impact. SN - 1556-3669 UR - https://www.unboundmedicine.com/medline/citation/30481134/Use_of_Telehealth_Screening_to_Detect_Diabetic_Retinopathy_and_Other_Ocular_Findings_in_Primary_Care_Settings_ L2 - https://www.liebertpub.com/doi/10.1089/tmj.2018.0016?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -