Evaluating the impact of optical coherence tomography in diabetic retinopathy screening for an Aboriginal population

O'Halloran, Richard A; Turner, Angus

doi:10.1111/ceo.13018

Cited by 14 publications

(23 citation statements)

References 27 publications

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“…The observed 47% DR and 16.2% STDR prevalence rates in the present study setting were higher than in previous DR studies in Indigenous populations (Table ): in previous studies , the crude DR prevalence rate ranged between 16.8% and 43.5% and for STDR it ranged between 5.0% and 10.8%. DR prevalence rates in non‐Indigenous population studies were between 21.9 % and 36.4% .…”

Section: Discussionsupporting

confidence: 70%

Diabetic retinopathy in a remote Indigenous primary healthcare population: a Central Australian diabetic retinopathy screening study in the Telehealth Eye and Associated Medical Services Network project

et al. 2018

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A novel telemedicine diabetic retinopathy screening service detected a higher prevalence of 'any' diabetic retinopathy and sight-threatening diabetic retinopathy in a remote primary care setting than reported in earlier surveys among Indigenous and non-Indigenous populations. Whether the observed high prevalence of diabetic retinopathy was attributable to greater detection, increasing diabetic retinopathy prevalence, local factors, or a combination of these requires further investigation and, potentially, specific primary care guidelines for diabetic retinopathy management in remote Australia. Clinical Trials registration number: Australia and New Zealand Clinical Trials Register (ANZCTR): ACTRN 12616000370404.

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Section: Discussionsupporting

confidence: 70%

Diabetic retinopathy in a remote Indigenous primary healthcare population: a Central Australian diabetic retinopathy screening study in the Telehealth Eye and Associated Medical Services Network project

et al. 2018

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“…E-learning is an effective alternative strategy that provides an opportunity to improve the skill of GPs continuously. On the other hand, optical coherence tomography, along with fundus photography, was used for screening of DR in some studies; however, this remains controversial [36, 37].…”

Section: Discussionmentioning

confidence: 99%

Modeling a Telemedicine Screening Program for Diabetic Retinopathy in Iran and Implementing a Pilot Project in Tehran Suburb

Safi

Ahmadieh

Katibeh

et al. 2019

Journal of Ophthalmology

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Purpose. To model a community-based telescreening program for diabetic retinopathy (DR) in Iran and to implement a pilot project at the Iranian Diabetes Society (IDS) branch in a Tehran suburb. Methods. In this mixed model study, a web application called the “Iranian Retinopathy Teleophthalmology Screening (IRTOS)” was launched. The educational course for DR screening was established for general practitioners (GPs). Registered patients in IDS branch were recalled for fundus photography; images were transferred to the reading center via IRTOS to be graded by GPs, and patients were informed about the results via mobile messaging. All images were independently reviewed by a retina specialist as the gold standard. Patients who required further assessment were referred to an eye hospital. Results. Overall, 604 subjects with diabetes were screened; of these, 50% required referral. The sensitivity and specificity for diagnosis of any stage of DR by trained GPs were 82.8% and 86.2%, respectively, in comparison to the gold standard. The corresponding values for detecting any stage of diabetic macular edema (DME) were 63.5% and 96.6%, respectively. Conclusions. Telescreening was an effective method for detecting DR in a Tehran suburb. This screening model demonstrated its capacity for promoting diabetic eye care services at the national level. However, the sensitivity for detecting DME needs to be improved by modifying the referral pathway and promoting the skill of GPs.

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“…29 In three of these teleophthalmology models Indigenous health workers in Australia were trained to take fundus images. 35 36 42 Two further models from Australia focused on technical aspects of the screening programme, such as addition of optical coherence tomography imaging 47 and the use of direct ophthalmoscopy compared with fundus BMJ Global Health cameras. 48 A further model described mobile vision screening for children in Australia (aged 0-16 years) integrated within an existing ear screening programme visiting schools.…”

Section: Characteristics Of Implemented Service Delivery Modelsmentioning

confidence: 99%

Eye care delivery models to improve access to eye care for Indigenous peoples in high-income countries: a scoping review

et al. 2021

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PurposeGlobally, there are ~370 million Indigenous peoples. Indigenous peoples typically experience worse health compared with non-Indigenous people, including higher rates of avoidable vision impairment. Much of this gap in eye health can be attributed to barriers that impede access to eye care services. We conducted a scoping review to identify and summarise service delivery models designed to improve access to eye care for Indigenous peoples in high-income countries.MethodsSearches were conducted on MEDLINE, Embase and Global Health in January 2019 and updated in July 2020. All study designs were eligible if they described a model of eye care service delivery aimed at populations with over 50% Indigenous peoples. Two reviewers independently screened titles, abstracts and full-text articles and completed data charting. We extracted data on publication details, study context, service delivery interventions, outcomes and evaluations, engagement with Indigenous peoples and access dimensions targeted. We summarised findings descriptively following thematic analysis.ResultsWe screened 2604 abstracts and 67 studies fulfilled our eligibility criteria. Studies were focused on Indigenous peoples in Australia (n=45), USA (n=11), Canada (n=7), New Zealand (n=2), Taiwan (n=1) and Greenland (n=1). The main disease focus was diabetic retinopathy (n=30, 45%), followed by ‘all eye care’ (n=16, 24%). Most studies focused on targeted interventions to increase availability of services. Fewer than one-third of studies reported involving Indigenous communities when designing the service. 41 studies reflected on whether the model improved access, but none undertook rigorous evaluation or quantitative assessment.ConclusionsThe geographical and clinical scope of service delivery models to improve access to eye care for Indigenous peoples in high-income countries is narrow, with most studies focused on Australia and services for diabetic retinopathy. More and better engagement with Indigenous communities is required to design and implement accessible eye care services.

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Evaluating the impact of optical coherence tomography in diabetic retinopathy screening for an Aboriginal population

Cited by 14 publications

References 27 publications

Diabetic retinopathy in a remote Indigenous primary healthcare population: a Central Australian diabetic retinopathy screening study in the Telehealth Eye and Associated Medical Services Network project

Diabetic retinopathy in a remote Indigenous primary healthcare population: a Central Australian diabetic retinopathy screening study in the Telehealth Eye and Associated Medical Services Network project

Modeling a Telemedicine Screening Program for Diabetic Retinopathy in Iran and Implementing a Pilot Project in Tehran Suburb

Eye care delivery models to improve access to eye care for Indigenous peoples in high-income countries: a scoping review

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