The role of tele-ophthalmology in diabetic retinopathy screening

Kalogeropoulos, Dimitrios; Kalogeropoulos, Chris; Stefaniotou, Maria; Neofytou, Marios

doi:10.1016/j.optom.2019.12.004

Cited by 35 publications

(30 citation statements)

References 41 publications

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“…Teleophthalmology programs have facilitated the identification of DR cases by utilizing digital retinal imaging [ 5 ]; additionally, teleophthalmology based on mobile imaging units can ameliorate DR screening and decrease the possibility of poor compliance or lost follow-up appointments [ 6 ]. The combination of teleophthalmology with portable devices may further increase access to eye care in underserved populations.…”

Section: Introductionmentioning

confidence: 99%

Diabetic retinopathy screening in urban primary care setting with a handheld smartphone-based retinal camera

Queiroz

Carvalho²,

Bortoto

et al. 2020

Acta Diabetol

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Aims To evaluate diabetic retinopathy (DR) screening with a portable handheld smartphone-based retinal camera and telemedicine in an urban primary healthcare setting and to evaluate the learning curve for image acquisition, performed by healthcare personnel without previous experience in retinal imaging. Methods This was a prospective study that enrolled patients with type 2 diabetes mellitus (T2DM) followed at a primary healthcare unit in São Paulo, Brazil. After a brief training in image acquisition, there was further continuous feedback given by a retina specialist during the remote image reading process. Each patient underwent two fundus and one anterior ocular segment images per eye, after mydriasis. Patients were classified according to the need of referral. Results A total of 627 adult individuals with T2DM underwent retinal evaluation. The population was composed by 63.2% female individuals, age median of 66 years, diabetes duration 10.7 ± 8.2 years and HbA1c 7.7 ± 1.9% (61 + 20.8 mmol/mol). The most prevalent associated comorbidities were arterial hypertension (80.3%) and dyslipidemia (50.2%). Referral decision was possible in 81.2% patients. Most patients had absent or non-referable DR; the main ocular media opacity detected was cataract. After the 7th day of image acquisition, the daily rate of patients whose images allowed clinical decision was maintained above 80%. A higher HbA1c was associated with referable DR. Conclusions A low-cost DR screening strategy with a handheld device and telemedicine is feasible and has the potential to increase coverage of DR screening in underserved areas; the possibility of mobile units is relevant for DR screening in the context of COVID-19 pandemic. This article belongs to the topical collection Eye Complications of Diabetes, managed by Giuseppe Querques.

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Section: Introductionmentioning

confidence: 99%

Diabetic retinopathy screening in urban primary care setting with a handheld smartphone-based retinal camera

Queiroz

Carvalho²,

Bortoto

et al. 2020

Acta Diabetol

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“…58 Telescreening approaches may include temporary mobile DR screening services whereby teams visit communities for short periods, centralized image analysis, or a combination of both. [59][60][61][62] Telescreening is usually cheaper and preferred by patients compared with traditional surveillance techniques. 63 Telescreening has been used in different screening programs, including the OPHDIAT® program in France; 59 the Remote Outreach DR Screening Service in Australia, which increased screening rates four-fold; 64 and the Sankara Nethralaya Teleophthalmology Project (SNTOP) and Aravind Teleophthalmology Network (ATN) in India, which estimated that 150 patients could be screened per day, with a single ophthalmologist making the final diagnoses remotely.…”

Section: Developments In Dr Screening: Telescreening and Aimentioning

confidence: 99%

<p>A Review of Advancements and Evidence Gaps in Diabetic Retinopathy Screening Models</p>

Pearce¹,

Sivaprasad²

2020

OPTH

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Diabetic retinopathy (DR) is a microvascular complication of diabetes with a prevalence of ~35%, and is one of the leading causes of visual impairment in people of working age in most developed countries. The earliest stage of DR, non-proliferative DR (NPDR), may progress to sight-threatening DR (STDR). Thus, early detection of DR and active regular screening of patients with diabetes are necessary for earlier intervention to prevent sight loss. While some countries offer systematic DR screening, most nations are reliant on opportunistic screening or do not offer any screening owing to limited healthcare resources and infrastructure. Currently, retinal imaging approaches for DR screening include those with and without mydriasis, imaging in single or multiple fields, and the use of conventional or ultra-wide-field imaging. Advances in telescreening and automated detection facilitate screening in previously hard-to-reach communities. Despite the heterogeneity in approaches to fit local needs, an evidence base must be created for each model to inform practice. In this review, we appraise different aspects of DR screening, including technological advances, identify evidence gaps, and propose several studies to improve DR screening globally, with a view to identifying patients with moderate-to-severe NPDR who would benefit if a convenient treatment option to delay progression to STDR became available.

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“…There is an increasing demand for online eye care hospitals to treat the diabetic patient by overcoming the challenges of viable, practical and clinically proven solutions. 8 Further, the risk of diabetic retinopathy can be minimized through proper education of patients and maintenance of blood glucose level.…”

Section: Introductionmentioning

confidence: 99%

Cloud‐based onboard prediction and diagnosis of diabetic retinopathy

Sundharamurthy¹,

Kaliappan

2021

Concurrency and Computation

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Diabetic retinopathy remains the most daunting microvascular complication of diabetic disease. Major risk factors of diabetic retinopathy include long-term diabetics, improper blood glucose level, and dyslipidemia. In order to investigate the presence of diabetic retinopathy-related features and to deal with the diagnosis of various diabetic severity stages, there is a need for a cloud-based automated screening system. So, the development of novel biomarkers should take the advantage of objective measurement and evaluation indicating the biological and pathogenic processes to all the therapeutic interventions. Current state-of-the-art research studies lack accommodating large sample size, cross-validation among the diverse populations, time, and cost-effective diagnosis techniques. To overcome these challenges, a cloud-based diabetic retinopathy prediction system is proposed using the recurrent convolution neural network classifier model. The proposed prediction system can provide risk stratification, optimized resource allocation, a severe form of disease prediction, risk control, and preventive interventions during the screening and diagnosis process. It also provides prognostic information to patients stating various cost-effective predictive responses according to treatment modalities. Moreover, the proposed system clinical decision-making will outperform the existing classifiers in terms of prediction accuracy, sensitivity, specificity, precision, recall, and F1-score.

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The role of tele-ophthalmology in diabetic retinopathy screening

Cited by 35 publications

References 41 publications

Diabetic retinopathy screening in urban primary care setting with a handheld smartphone-based retinal camera

Diabetic retinopathy screening in urban primary care setting with a handheld smartphone-based retinal camera

<p>A Review of Advancements and Evidence Gaps in Diabetic Retinopathy Screening Models</p>

Cloud‐based onboard prediction and diagnosis of diabetic retinopathy

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