title: Teleretinal screening for diabetic retinopathy in six Los Angeles urban safety-net clinics: initial findings.
abstract: Diabetic retinopathy is a leading cause of blindness in US adults. This paper presents initial results of a teleretinal screening project for diabetic retinopathy involving six Los Angeles safety net clinics. A total of 1,943 patients have been screened for diabetic retinopathy by three ophthalmologist readers, with 416 receiving a recommendation for referral to specialty care. Of the cases recommended for referral, 24 had proliferative diabetic retinopathy, 62 had severe non-proliferative diabetic retinopathy (NPDR), 60 had moderate NPDR, 19 had mild NPDR, 138 had a non-diabetic condition, such as glaucoma, 63 had clinically significant macular edema without retinopathy and 50 had non-gradable images. Between 3% and 12.2% of retinal images taken at the clinics were assessed by readers as inadequate for any interpretation. The study shows the feasibility and challenges of teleretinal screening for diabetic retinopathy in urban areas facing specialist shortages and an overburdened, under-resourced safety net care-delivery system.
authors.affiliation: Center for Biomedical Informatics, Charles Drew University of Medicine and Science, Los Angeles, California, USA.
authors.forename: Omolola
authors.initials: O
authors.lastname: Ogunyemi
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Terrien
authors.forename: Alicia
authors.initials: A
authors.lastname: Eccles
authors.forename: Lauren
authors.initials: L
authors.lastname: Patty
authors.forename: Sheba
authors.initials: S
authors.lastname: George
authors.forename: Allison
authors.initials: A
authors.lastname: Fish
authors.forename: Senait
authors.initials: S
authors.lastname: Teklehaimanot
authors.forename: Ramarao
authors.initials: R
authors.lastname: Ilapakurthi
authors.forename: Otaren
authors.initials: O
authors.lastname: Aimiuwu
authors.forename: Richard
authors.initials: R
authors.lastname: Baker
mesh_terms: D000328:Adult; D000554:Ambulatory Care Facilities; D003153:Community Health Services; D003930:Diabetic Retinopathy / Q000175:diagnosis*; D006801:Humans; D015141:Los Angeles; D008403:Mass Screening / Q000379:methods; D010781:Photography / Q000379:methods*; D011320:Primary Health Care; D012017:Referral and Consultation / Q000706:statistics & numerical data; D012160:Retina / Q000473:pathology*; D042262:Retinoscopy; D017216:Telemedicine; D014505:Urban Population