Teleretinal Imaging to Screen for Diabetic Retinopathy in the Veterans Health Administration

Cavallerano, Anthony; Conlin, Paul R.

doi:10.1177/193229680800200106

Cited by 43 publications

(34 citation statements)

References 28 publications

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“…Patients express satisfaction with this screening approach. 36-38 Clinic personnel can be trained to operate the camera and upload images to a reading center. 33,39 There is growing evidence that DR screening programs, combined with telemedicine, are cost-effective interventions.…”

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confidence: 99%

Diabetes Eye Screening in Urban Settings Serving Minority Populations

et al. 2015

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The use of a nonmydriatic camera for retinal imaging combined with the remote evaluation of images at a telemedicine reading center has been advanced as a strategy for diabetic retinopathy (DR) screening, particularly among patients with diabetes mellitus from ethnic/racial minority populations with low utilization of eye care.OBJECTIVE To examine the rate and types of DR identified through a telemedicine screening program using a nonmydriatic camera, as well as the rate of other ocular findings. DESIGN, SETTING, AND PARTICIPANTSA cross-sectional study (Innovative Network for Sight [INSIGHT]) was conducted at 4 urban clinic or pharmacy settings in the United States serving predominantly ethnic/racial minority and uninsured persons with diabetes. Participants included persons aged 18 years or older who had type 1 or 2 diabetes mellitus and presented to the community-based settings. MAIN OUTCOMES AND MEASURESThe percentage of DR detection, including type of DR, and the percentage of detection of other ocular findings.RESULTS A total of 1894 persons participated in the INSIGHT screening program across sites, with 21.7% having DR in at least 1 eye. The most common type of DR was background DR, which was present in 94.1% of all participants with DR. Almost half (44.2%) of the sample screened had ocular findings other than DR; 30.7% of the other ocular findings were cataract.CONCLUSIONS AND RELEVANCE In a DR telemedicine screening program in urban clinic or pharmacy settings in the United States serving predominantly ethnic/racial minority populations, DR was identified on screening in approximately 1 in 5 persons with diabetes. The vast majority of DR was background, indicating high public health potential for intervention in the earliest phases of DR when treatment can prevent vision loss. Other ocular conditions were detected at a high rate, a collateral benefit of DR screening programs that may be underappreciated.

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confidence: 99%

Diabetes Eye Screening in Urban Settings Serving Minority Populations

et al. 2015

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“…These photographs are forwarded to a reading center, where an eye care professional evaluates and makes recommendations for follow-up and further evaluation. 18 The Veteran Affairs screening program has improved delivery of eye care to veterans by decreasing the distance traveled for screening eye examinations, screening patients at younger ages, and increasing the number of known diabetic retinopathy cases. 16 …”

Section: Hospital-based Evaluationsmentioning

confidence: 99%

The Current State of Teleophthalmology in the United States

et al. 2017

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Telemedicine services facilitate the evaluation, diagnosis, and management of the remote patient. Telemedicine has rapidly flourished in the United States and has improved access to care, outcomes, and patient satisfaction. However, the use of telemedicine in ophthalmology is currently in its infancy and has yet to gain wide acceptance. Current models of telemedicine in ophthalmology are largely performed via “store and forward” methods, but remote monitoring and interactive modalities exist. Although studies have examined the effects of telemedicine, few reports have characterized its current status. We perform a descriptive analysis of the current state of teleophthalmology in the United States. We describe the use of teleophthalmology in the hospital and outpatient settings. We also review the applications to retinopathy of prematurity, diabetic retinopathy, age-related macular degeneration, and glaucoma, as well as anticipated barriers and hurdles for the future adoption of teleophthalmology. With ongoing advances in teleophthalmology, these models may provide earlier detection and more reliable monitoring of vision-threatening diseases.

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“…A certified teleretinal imager captured the retinal images with a TRC-NW6S nonmydriatic digital fundus camera (Topcon Medical Systems, Inc, Oakland, NJ) following the Veterans Health Administration Teleretinal Imaging Program protocol. 13 The images were 45 degrees across with three fields per eye: macula centered, disc centered, and superior temporal vascular arcade centered. All three images were evaluated when grading the photographs as part of the study.…”

Section: Subjectsmentioning

confidence: 99%

Arteriole Tortuosity Associated with Diabetic Retinopathy and Cholesterol

Weiler¹,

Engelke²,

Moore³

et al. 2015

Optometry and Vision Science

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First, RVT, particularly for venules, is difficult to grade consistently; therefore, future studies examining tortuosity should focus on arterioles. Second, the model indicates that there is an association between vessel changes, DR, and systemic cholesterol levels. Although DR and RVT are readily available to assess concurrently on a photograph, the addition of cholesterol to this model indicates that patients with RVT may warrant further follow-up on health factors, such as cholesterol levels.

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Teleretinal Imaging to Screen for Diabetic Retinopathy in the Veterans Health Administration

Cited by 43 publications

References 28 publications

Diabetes Eye Screening in Urban Settings Serving Minority Populations

Diabetes Eye Screening in Urban Settings Serving Minority Populations

The Current State of Teleophthalmology in the United States

Arteriole Tortuosity Associated with Diabetic Retinopathy and Cholesterol

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