Snapshot of Teleretinal Screening for Diabetic Retinopathy at the West Los Angeles Medical Center

Abstract

We found, although only 15% of patients were diagnosed with DR from teleretinal screening, more than 50% of patients were referred to eye clinic. In addition, of all screened patients, there was a high rate of not returning to the Veterans Affairs (VA) for eye care.

The Role of Telemedicine, In-Home Testing and Artificial Intelligence to Alleviate an Increasingly Burdened Healthcare System: Diabetic Retinopathy

“…Several DR telescreening models have been implemented. Retinal images are generally acquired by trained primary care physicians, technicians, ophthalmic photographers and nurses [ 7 , 10 , 12 , 13 , 15 , 17 , 18 , 20 , 22 , 23 , 25 – 27 , 27 – 31 , 53 – 60 , 63 – 65 , 68 – 72 , 51 – 53 , 53 , 97 – 101 , 57 , 58 , 58 , 59 , 26 – 30 , 64 , 64 , 65 , 65 , 48 – 55 , 58 – 60 , 63 – 67 , 81 , 82 , 82 , 83 , 79 – 83 ].…”

“…There can also be two or more masked reviewers, who check the same data, and a third reviewer or more for inconsistent decisions [ 18 , 52 , 80 ]. Prior to commencement of work, some readers have completed a special training program or obtained a certificate for retinal evaluation [ 17 , 18 , 48 , 52 ].…”

“…There were also significant problems regarding telemedicine programs associated with a growing demand for trained/certified eye fundus photographers [ 81 ] and image readers [ 18 , 63 ]. As a solution to that problem, training in picture-taking could be offered to nurses and technicians [ 12 , 15 , 18 , 22 , 23 , 27 , 31 – 34 , 38 , 42 – 45 , 47 , 48 , 50 , 52 – 57 , 60 , 63 , 64 , 68 , 70 – 72 , 74 , 79 – 81 , 98 – 100 ]. One promising solution was in-home testing, where patients themselves took pictures of their retinas [ 97 ].…”

The Nonmydriatic Fundus Camera in Diabetic Retinopathy Screening: A Cost-Effective Study with Evaluation for Future Large-Scale Application

“…As DR is a multiprofessional and a multidimensional eye disease, a multidisciplinary group was involved in the project, including general practitioners, diabetes experts, administrative staff, nurses, epidemiologists, and ophthalmologists. The involvement of different healthcare professionals in the screening programme could influence the resources absorption and the optimisation of the screening pathway [12, 13, 16–18]. …”

Teleophthalmology

“…This Early detection and treatment of diabetic retinopathy with the help of tele-ophthalmology has been possible in many rural and urban areas. Fundus photography has proven to be beneficial for patients who do not attend the regular necessary eye exams [11]. The Indian Health Service-Joslin Vision Network has performed diabetic retinopathy screening for American Indians and Alaskan Natives since 2001.…”