Diabetes eye screening in urban settings serving minority populations: detection of diabetic retinopathy and other ocular findings using telemedicine.
OBJECTIVE
The use of a nonmydriatic camera for retinal imaging combined with the remote evaluation of images at a telemedicine reading center has been advanced as a strategy for diabetic retinopathy (DR) screening, particularly among patients with diabetes mellitus from ethnic/racial minority populations with low utilization of eye care.


OBJECTIVE
To examine the rate and types of DR identified through a telemedicine screening program using a nonmydriatic camera, as well as the rate of other ocular findings.


METHODS
A cross-sectional study (Innovative Network for Sight [INSIGHT]) was conducted at 4 urban clinic or pharmacy settings in the United States serving predominantly ethnic/racial minority and uninsured persons with diabetes. Participants included persons aged 18 years or older who had type 1 or 2 diabetes mellitus and presented to the community-based settings.


METHODS
The percentage of DR detection, including type of DR, and the percentage of detection of other ocular findings.


RESULTS
A total of 1894 persons participated in the INSIGHT screening program across sites, with 21.7% having DR in at least 1 eye. The most common type of DR was background DR, which was present in 94.1% of all participants with DR. Almost half (44.2%) of the sample screened had ocular findings other than DR; 30.7% of the other ocular findings were cataract.


CONCLUSIONS
In a DR telemedicine screening program in urban clinic or pharmacy settings in the United States serving predominantly ethnic/racial minority populations, DR was identified on screening in approximately 1 in 5 persons with diabetes. The vast majority of DR was background, indicating high public health potential for intervention in the earliest phases of DR when treatment can prevent vision loss. Other ocular conditions were detected at a high rate, a collateral benefit of DR screening programs that may be underappreciated.
Department of Ophthalmology, School of Medicine, University of Alabama at Birmingham.
Cynthia
C
Owsley
Department of Ophthalmology, School of Medicine, University of Alabama at Birmingham2Department of Epidemiology, School of Public Health, University of Alabama at Birmingham.
Gerald
G
McGwin
Department of Public Health Sciences, Miller School of Medicine, University of Miami, Miami, Florida.
David J
DJ
Lee
Bascom Palmer Eye Institute, Miller School of Medicine, University of Miami, Miami, Florida.
Byron L
BL
Lam
Wilmer Eye Institute, Dana Center for Preventive Ophthalmology, The Johns Hopkins School of Medicine, Baltimore, Maryland.
David S
DS
Friedman
Wilmer Eye Institute, Dana Center for Preventive Ophthalmology, The Johns Hopkins School of Medicine, Baltimore, Maryland6Department of Epidemiology, Wake Forest School of Medicine, Winston-Salem, North Carolina7Department of Ophthalmology, Wake Forest Sc.
Emily W
EW
Gower
Wills Eye Hospital, Thomas Jefferson University, Philadelphia, Pennsylvania.
Julia A
JA
Haller
Wills Eye Hospital, Thomas Jefferson University, Philadelphia, Pennsylvania.
Lisa A
LA
Hark
Vision Health Initiative, Division of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta, Georgia.
Jinan
J
Saaddine
D000328:Adult; D003430:Cross-Sectional Studies; D003930:Diabetic Retinopathy / Q000097:blood / Q000175:diagnosis* / Q000208:ethnology; D003941:Diagnostic Techniques, Ophthalmological; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D008913:Minority Groups; D015995:Prevalence; D011379:Prognosis; D012189:Retrospective Studies; D017216:Telemedicine / Q000379:methods*; D014481:United States / Q000453:epidemiology; D014505:Urban Population / Q000706:statistics & numerical data*
D006442:Glycated Hemoglobin