Remote screening of retinal and optic disc diseases using handheld nonmydriatic cameras in programmed routine occupational health checkups onsite at work centers

Abstract

Purpose To evaluate the first year outcomes of a remote screening program for detection of retinal diseases using handheld nonmydriatic cameras in occupational routine checkups performed onsite at work centers. Methods Cross-sectional, first year screening program outcomes audit. Participants were volunteers recruited from staff within work centers. Retinal fundus images were captured by technicians, and images and data were anonymized and sent securely to a remote server. A team of ophthalmologists, all retinal specialists, remotely read the images using a custom-made software and sent telematic reports of findings within 24-48 h. The main items evaluated were the detection of retinal abnormalities and the relationship between retinal findings and demographic data such as age and sex. Results A total of 19,881 workers were evaluated in 52 centers. Mean age was 41.1 years old, 43.9% men and 56.1% women. Mean duration of the test was around 2 min. Of the workers, 7.8% presented abnormalities in retinal fundus images, being the main findings choroidal nevus (2.4%), macular pigment abnormalities (1.5%), glaucomatous optic disc (1.2%), and macular signs of high myopia (1.1%). The presence of abnormalities was associated with greater age, being 5%, 7.9%, 12.6%, and 19.7% in workers less than 40 years, from 40 to 49, 50-59, and ≥ 60 years (p < 0.05), respectively. Men had more abnormalities in retinal fundus images than women (8.6 vs. 7.2; p < 0.05 RR: 1.2; CI 1092-1322). Conclusions Mass screening of retinal and optic disc abnormalities during occupational health routine checkups is a feasible, quick, and efficient tool for early detection of potential vision-threatening disease markers.

Validation of an autonomous artificial intelligence–based diagnostic system for holistic maculopathy screening in a routine occupational health checkup context

“…Currently, screening programs in most countries focus on DR, probably for cost-effectiveness reasons. Our study population is relatively young, and a priori, healthy, despite previous studies that report alterations in fundus images in almost 8% of cases in this type of population [37]. Although these alterations do not usually represent serious or urgent cases, any pathology in this population, young and working, can have significant socio-economic repercussions.…”

“…Despite the fact that the objective of this study is not an economic evaluation, the use of Fig. 3 Receiver operating curve for the combined and individual algorithms automatic detection software can reduce previously reported costs, lower than 10 euros per patient [37].…”

“…From the study population, 1786 (63%) were male and 1053 female (37%) (see Table 1 for a detailed breakdown). Participants of this study were enrolled in a consecutive series during routine occupational health checkups offered by their employer as medical benefits [37]. All ophthalmologic check-ups were performed by a single provider (Optretina, Sant Cugat, Spain).…”

One-field, two-field and five-field handheld retinal imaging compared with standard seven-field Early Treatment Diabetic Retinopathy Study photography for diabetic retinopathy screening

“…These compact cameras may be more widely deployed in underserved areas and can be used by allied health personnel, primary care physicians and non-medical staff with proper training. [3][4][5] Hence, it is essential that these devices accurately identify the DR severity in patients' eyes if diabetic retinopathy screening programmes (DRSPs) were to rely on these instruments.…”