Telemedicine for screening diabetic retinopathy: The NO BLIND Italian multicenter study

Abstract

Aims Diabetic retinopathy (DR) represents the main cause of blindness among adults in the industrialized Countries. Use of telemedicine could offer an easy, smart specialist fundus oculi examination, as well as putting in a screening programme many patients who otherwise would be excluded. Materials and methods The NO BLIND is a transversal, multicentre, observational study. Its pilot phase involved nine public outpatient clinics for 6 months. As endpoint of the study, we assessed the prevalence of DR by retinography in a subset of the Italian population. Patients' fundus oculi photos were performed by trained diabetologists through a digital smart ophthalmoscope. Results According to our endpoint, in the final study population (n = 1461), obtained excluding patients for whom retinography was not able to provide any diagnosis, DR prevalence was equal to 15.5%. According to the receiver operating characteristic (ROC) curve performed, we can observe how retinography appears a highly accurate method to detect DR (AUROC 0.971, 95% confidence interval, 0.954‐0.989), with a specificity of the 100% and a sensitivity of the 94.3%. Conclusions Our findings, in an Italian setting, confirm main data in the literature about DR prevalence. Hence, telemedicine could represent an accurate, fast, and cheap method for screening of DR.

The Diabetic Cardiomyopathy: The Contributing Pathophysiological Mechanisms

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Impact of SGLT2 Inhibitors on Heart Failure: From Pathophysiology to Clinical Effects

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Role of Albuminuria in Detecting Cardio-Renal Risk and Outcome in Diabetic Subjects

“…Although nephrologists and cardiologists have been paying attention to the study of proteinuria for years, type 2 diabetes mellitus (T2DM) is currently considered a condition in which increased urine albumin excretion ascertainsthe highest cardio-renal risk [6][7][8]. In fact, diabetes is a condition by itself associated, through various mechanisms [9][10][11], with a high risk of both micro-and macrovascular complications [12][13][14][15][16]. Moreover, proteinuria reduction in diabetic subjects by several treatments lowers the risk of both renal and cardiovascular disease progression [17].…”