title: Snapshot of Teleretinal Screening for Diabetic Retinopathy at the West Los Angeles Medical Center.
abstract: The West Los Angeles Veterans Affairs Medical Center is a large urban facility with a robust teleretinal screening program in primary care clinic, established in 2006. The purpose of this article is to provide a snapshot of teleretinal screening at this site.
  
  
  
  Diabetic patients from 2012 were analyzed with a prospective cohort study. Demographic information, results of teleretinal screening, referral to eye clinic, and loss to follow-up (defined as no eye care within 2 years) were collected.
  
  
  
  Of 516 patients with diabetes screened with teleretinal imaging, 120 patient charts were reviewed for data analysis. Teleretinal imaging diagnosed 15% (18/120) of patients with varying stages of nonproliferative diabetic retinopathy (DR). Of patients screened, 55.8% (67/120) of the patients were referred to an eye clinic for further ophthalmic evaluation. Nondiabetic retinopathy reasons for eye clinic referral included glaucoma suspect (13.3%, 16/120) and age-related macular degeneration (10.0%, 12/120). Of all patients screened, 37.5% (45/120) of them were lost to follow-up, defined as no teleretinal screening or eye clinic appointment within 2 years. Patients who lived farther away from clinic had a higher risk of loss to follow-up (p = 0.04).
  
  
  
  We found, although only 15% of patients were diagnosed with DR from teleretinal screening, more than 50% of patients were referred to eye clinic. In addition, of all screened patients, there was a high rate of not returning to the Veterans Affairs (VA) for eye care.
authors.affiliation: 1 Stein Eye Institute , UCLA, Los Angeles, California.|2 Doheny Eye Institute , UCLA, Los Angeles, California.|3 Ophthalmology Department, West Los Angeles Veterans Affairs Medical Center , Los Angeles, California.
authors.forename: Irena
authors.initials: I
authors.lastname: Tsui
authors.affiliation: 1 Stein Eye Institute , UCLA, Los Angeles, California.
authors.forename: Margaret A
authors.initials: MA
authors.lastname: Havunjian
authors.affiliation: 1 Stein Eye Institute , UCLA, Los Angeles, California.
authors.forename: John A
authors.initials: JA
authors.lastname: Davis
authors.affiliation: 1 Stein Eye Institute , UCLA, Los Angeles, California.|3 Ophthalmology Department, West Los Angeles Veterans Affairs Medical Center , Los Angeles, California.
authors.forename: JoAnn A
authors.initials: JA
authors.lastname: Giaconi
mesh_terms: D000368:Aged; D000554:Ambulatory Care Facilities / Q000458:organization & administration; D003930:Diabetic Retinopathy / Q000175:diagnosis*; D005260:Female; D006801:Humans; D015141:Los Angeles; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D011446:Prospective Studies; D012017:Referral and Consultation / Q000458:organization & administration; D012164:Retinal Diseases / Q000175:diagnosis; D012189:Retrospective Studies; D012959:Socioeconomic Factors; D017216:Telemedicine / Q000379:methods*; D014481:United States; D014493:United States Department of Veterans Affairs
keywords: behavioral health; ophthalmology; telehealth; telemedicine