Impact of a tele-medicine diabetic retinopathy screening program on improving visual acuity
Methods: Tele-I-CARE is a nonrandomized prospective cohort IRB-approved study aimed at increasing DR screening and promoting eye health in federally qualified primary care clinics in Rochester, NY. Patients’ distance visual acuity (VA) is measured using Snellen charts and nonmydriatic fundus photos are taken. The level of vision and photos are reviewed by an ophthalmologist (RSR) and visual impairment as defined as <20/40 in either eye and DR are noted with appropriate follow up arranged at the affiliated ophthalmology clinic. Screening data from 400 people were reviewed and 132 who followed up with the ophthalmology clinic had best corrected visual acuity recorded. Snellen acuities were converted to LogMar for analysis and a paired T-test was used to compare mean screening, follow-up and best corrected VA.
Results: Mean LogMAR VA with Snellen equivalents (SE) were as follows: 0.357 LogMar (SE 20/46) at the screening visit; 0.255 LogMar (SE 20/36) at initial follow up; and 0.201 LogMar (SE 20/32) final best corrected. Comparison of the mean VA at the screening versus initial VA at follow up, mean VA at screening versus final best corrected VA, and mean initial VA at follow up versus final best corrected VA all yielded a p of < 0.001.
Conclusion: Primary care based vision and retinopathy surveillance programs can ultimately have a significant impact on improving access to care and vision in an underserved population.
Learning Areas:Administer health education strategies, interventions and programs
Implementation of health education strategies, interventions and programs
Provision of health care to the public
Evaluate the impact of a telemedicine diabetic retinopathy screening program on improving visual acuity.
Keyword(s): Diabetes, Underserved
Qualified on the content I am responsible for because: I am a second year resident in ophthalmology at the University of Rochester School of Medicine and Dentistry. I work with Dr. Rajeev Ramchandran on a project funded by the Greater Rochester Health Foundation for implementing teleophthalmology as part of a diabetic retinopathy detection and treatment program in primary care clinics that target disadvantaged populations in inner city Rochester, NY.
Any relevant financial relationships? No
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.