Telemedicine boosts rural diabetic retinopathy screening rates by 40 per cent

Benedict Jephcote
Wed, 24 May 2017
Telemedicine boosts rural diabetic retinopathy screening rates by 40 per cent
Telescreening people's eyes has increased diabetic retinopathy (DR) screening rates in rural areas of America to 40 per cent, according to new research.

During a three-year study a team from the University of North Carolina at Chapel Hill, USA, focused on 1,661 people with diabetes and their eyes.

They wanted to see whether telescreening could help increase early detection because currently 50 per cent of people with diabetes are not being screened for DR.

Speaking to MedPage Today, Dr Seema Garg who led the study, said: "Reducing vision loss from DR is a public health imperative. Telemedicine screening can increase rates of surveillance, reduce socioeconomic disparities, and increase access to care, ultimately preventing vision-threatening DR and improving visual outcomes and quality of life for patients with diabetes.

"I was seeing many patients coming in to my clinic blind from diabetes, and as retinal specialists we know this is a completely preventable disease. We can prevent 90 per cent of severe blinding disease from diabetic retinopathy."

Telescreening for the study involved training nurses and technicians as retinal camera operators. They used special digital cameras to capture single 45-degree macular-centered images in both eyes which were then sent for evaluation by retinal specialists.

Within 24 hours a report on the person's eyes had been compiled which was then sent to their doctor and included a diagnosis and recommendations for treatment or management of the condition.

By working in this way, Dr Garg said by the end of the trial 80 per cent of the participants had no trace of DR, they detected 11 per cent of people with a mild to moderate version of the condition and only nine per cent were found to have a severe form.

Of those people who were referred to an ophthalmologist for further recommendations of their condition 60 per cent completed the referral appointment.

Dr Garg added: "We can improve access to care for patients with diabetic retinopathy, because we are not even screening half of the patients with diabetes in the current paradigm, where we send our patients from the primary care setting to an ophthalmologist for retinal evaluation.

"The barriers to care are increasing. There are more economic pressures for patients, there are a greater number of diabetics, there's an epidemic proportion of diabetes. We know that in the current paradigm, our healthcare system will not be able to meet the needs of these patients."

Note that the UK has a very good retinopathy screening programme. All people with diabetes over 12 years-old are entitled, and encouraged, to attend a retinopathy screening appointment at least once a year.

The findings were published in the JAMA Ophthalmology journal.
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