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Use of Telehealth Screening to Detect Diabetic Retinopathy and Other Ocular Findings in Primary Care Settings.

Publication ,  Journal Article
Gao, X; Park, CH; Dedrick, K; Borkar, DS; Obeid, A; Reber, S; Federman, J
Published in: Telemed J E Health
September 2019

Purpose: To determine the incidence of diabetic retinopathy (DR) and other ocular findings in previously diagnosed diabetes using telehealth retinal screening with nonmydriatic fundus photography (nFP) in primary care physicians' offices.Methods: A retrospective study based on electronic chart review was performed. All diabetic patients who participated in the Wills Eye Hospital (WEH) telehealth retinal screening program from July 1, 2012 to February 20, 2017 were included. In addition to evaluation of DR, other eye pathologies of the retina were detected using nFP.Results: Overall, 9,946 diabetics participated in the WEH telehealth screening system. After exclusion of missing or unreadable images, 15,180 eyes of 7,624 (76.7%) patients were eligible for final analysis. A total of 1,269 (16.6%) patients were noted to have DR changes in at least one eye. Of those, 475 (37.4%) had mild nonproliferative DR (NPDR) in the more severely affected eye, 712 (56.1%) had moderate NPDR, 33 (2.6%) had severe NPDR, 19 (1.5%) had proliferative DR, and 30 (2.4%) have received pan-retinal photocoagulation previously. In addition, there was evidence of diabetic macular edema detectable on nFP in 34 eyes of 29 patients. Other ocular findings included hypertensive retinopathy (709, 9.3%), increased or asymmetric cup-to-disc ratio (562, 7.4%), age-related cataract (379, 5.0%), cotton-wool spots (221, 2.9%), choroidal nevus (74, 1.0%), age-related macular degeneration (AMD) (66, 0.9%), and epiretinal membrane (48, 0.6%). Patients with hypertensive retinopathy, glaucomatous findings, cataract, or AMD were significantly older (p < 0.001) than those without these ocular pathologies.Conclusion: The WEH Telehealth Screening Program identified DR in approximately one out of six patients and other ocular pathologies in over 25% of the diabetic population that received screenings in Philadelphia area primary care offices. Given the importance of early detection and routine eye care to prevent vision loss for DR patients, these findings have a significant impact.

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Published In

Telemed J E Health

DOI

EISSN

1556-3669

Publication Date

September 2019

Volume

25

Issue

9

Start / End Page

802 / 807

Location

United States

Related Subject Headings

  • United States
  • Telemedicine
  • Sex Distribution
  • Severity of Illness Index
  • Risk Assessment
  • Retrospective Studies
  • Retinoscopy
  • Probability
  • Primary Health Care
  • Middle Aged
 

Citation

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ICMJE
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Gao, X., Park, C. H., Dedrick, K., Borkar, D. S., Obeid, A., Reber, S., & Federman, J. (2019). Use of Telehealth Screening to Detect Diabetic Retinopathy and Other Ocular Findings in Primary Care Settings. Telemed J E Health, 25(9), 802–807. https://doi.org/10.1089/tmj.2018.0016
Gao, Xinxiao, Carl H. Park, Krista Dedrick, Durga S. Borkar, Anthony Obeid, Shae Reber, and Jay Federman. “Use of Telehealth Screening to Detect Diabetic Retinopathy and Other Ocular Findings in Primary Care Settings.Telemed J E Health 25, no. 9 (September 2019): 802–7. https://doi.org/10.1089/tmj.2018.0016.
Gao X, Park CH, Dedrick K, Borkar DS, Obeid A, Reber S, et al. Use of Telehealth Screening to Detect Diabetic Retinopathy and Other Ocular Findings in Primary Care Settings. Telemed J E Health. 2019 Sep;25(9):802–7.
Gao, Xinxiao, et al. “Use of Telehealth Screening to Detect Diabetic Retinopathy and Other Ocular Findings in Primary Care Settings.Telemed J E Health, vol. 25, no. 9, Sept. 2019, pp. 802–07. Pubmed, doi:10.1089/tmj.2018.0016.
Gao X, Park CH, Dedrick K, Borkar DS, Obeid A, Reber S, Federman J. Use of Telehealth Screening to Detect Diabetic Retinopathy and Other Ocular Findings in Primary Care Settings. Telemed J E Health. 2019 Sep;25(9):802–807.
Journal cover image

Published In

Telemed J E Health

DOI

EISSN

1556-3669

Publication Date

September 2019

Volume

25

Issue

9

Start / End Page

802 / 807

Location

United States

Related Subject Headings

  • United States
  • Telemedicine
  • Sex Distribution
  • Severity of Illness Index
  • Risk Assessment
  • Retrospective Studies
  • Retinoscopy
  • Probability
  • Primary Health Care
  • Middle Aged