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Toronto tele-retinal screening program for detection of diabetic retinopathy and macular edema.
Can J Ophthalmol. 2019 04; 54(2):203-211.CJ

Abstract

BACKGROUND

There are currently low rates of screening for diabetic retinopathy (DR) and sight-threatening diabetic macular edema (DME) in Ontario.

OBJECTIVE

To present results of the Toronto Tele-Retinal screening program for patients with diabetes mellitus and to evaluate thebenefit of optical coherence tomography (OCT) in combination with monoscopic colour fundus photographs for detection of DME.

METHODS

All electronic medical records for adults with type I and II diabetes mellitus screened through the Toronto Tele-Retinal screening program between September 2013 to August 2017 across 7 sc~reening sites in urban and rural settings were reviewed. Monoscopic colour fundus photographs were graded for presence or absence of DR and DME alone and in combination with OCT scans.

RESULTS

A total of 775 patient screens, consisting of 566 first-time screens and 209 re-screens were completed over the 48-month study period. Approximately 37% of all patients with a mean disease duration of 7years had never had an eye examination. Across the sample, 27% of patients had DR, with majority graded to have mild DR, whereas DME was detected in 5% of patients in at least 1 eye. Of all DME detected in the Toronto Tele-Retinal screening program, 38% required the use of adjunct OCT. Other pathologies, including age-related macular degeneration (19%) and glaucomatous or optic nerve findings (8%), were also identified.

CONCLUSION

Tele-retinal screening programs may circumvent low rates of DR screening for patients with diabetes mellitus and increase the rate of detection of DME with monoscopic colour fundus photographs and adjunct OCT.

Authors+Show Affiliations

Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ont., Canada.Department of Ophthalmology, Meir Medical Center, Kfar-Saba, Israel.South Riverdale Community Health Centre, Toronto, Ont., Canada.Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ont., Canada; Toronto Western Hospital, University Health Network, University of Toronto, Toronto, Ont., Canada.. Electronic address: michael.brent@uhn.ca.

Pub Type(s)

Comparative Study
Journal Article
Multicenter Study

Language

eng

PubMed ID

30975344

Citation

Felfeli, Tina, et al. "Toronto Tele-retinal Screening Program for Detection of Diabetic Retinopathy and Macular Edema." Canadian Journal of Ophthalmology. Journal Canadien D'ophtalmologie, vol. 54, no. 2, 2019, pp. 203-211.
Felfeli T, Alon R, Merritt R, et al. Toronto tele-retinal screening program for detection of diabetic retinopathy and macular edema. Can J Ophthalmol. 2019;54(2):203-211.
Felfeli, T., Alon, R., Merritt, R., & Brent, M. H. (2019). Toronto tele-retinal screening program for detection of diabetic retinopathy and macular edema. Canadian Journal of Ophthalmology. Journal Canadien D'ophtalmologie, 54(2), 203-211. https://doi.org/10.1016/j.jcjo.2018.07.004
Felfeli T, et al. Toronto Tele-retinal Screening Program for Detection of Diabetic Retinopathy and Macular Edema. Can J Ophthalmol. 2019;54(2):203-211. PubMed PMID: 30975344.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Toronto tele-retinal screening program for detection of diabetic retinopathy and macular edema. AU - Felfeli,Tina, AU - Alon,Roy, AU - Merritt,Rebecca, AU - Brent,Michael H, Y1 - 2018/08/23/ PY - 2018/04/08/received PY - 2018/07/10/revised PY - 2018/07/11/accepted PY - 2019/4/13/entrez PY - 2019/4/13/pubmed PY - 2020/5/12/medline SP - 203 EP - 211 JF - Canadian journal of ophthalmology. Journal canadien d'ophtalmologie JO - Can J Ophthalmol VL - 54 IS - 2 N2 - BACKGROUND: There are currently low rates of screening for diabetic retinopathy (DR) and sight-threatening diabetic macular edema (DME) in Ontario. OBJECTIVE: To present results of the Toronto Tele-Retinal screening program for patients with diabetes mellitus and to evaluate thebenefit of optical coherence tomography (OCT) in combination with monoscopic colour fundus photographs for detection of DME. METHODS: All electronic medical records for adults with type I and II diabetes mellitus screened through the Toronto Tele-Retinal screening program between September 2013 to August 2017 across 7 sc~reening sites in urban and rural settings were reviewed. Monoscopic colour fundus photographs were graded for presence or absence of DR and DME alone and in combination with OCT scans. RESULTS: A total of 775 patient screens, consisting of 566 first-time screens and 209 re-screens were completed over the 48-month study period. Approximately 37% of all patients with a mean disease duration of 7years had never had an eye examination. Across the sample, 27% of patients had DR, with majority graded to have mild DR, whereas DME was detected in 5% of patients in at least 1 eye. Of all DME detected in the Toronto Tele-Retinal screening program, 38% required the use of adjunct OCT. Other pathologies, including age-related macular degeneration (19%) and glaucomatous or optic nerve findings (8%), were also identified. CONCLUSION: Tele-retinal screening programs may circumvent low rates of DR screening for patients with diabetes mellitus and increase the rate of detection of DME with monoscopic colour fundus photographs and adjunct OCT. SN - 1715-3360 UR - https://www.unboundmedicine.com/medline/citation/30975344/Toronto_tele_retinal_screening_program_for_detection_of_diabetic_retinopathy_and_macular_edema_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0008-4182(18)30385-5 DB - PRIME DP - Unbound Medicine ER -