title: Evidence for Telemedicine for Diabetic Retinal Disease.
abstract: According to current projections, the number of Americans with diabetes mellitus will increase from 27.8 million in 2007 to 60.7 million in 2030. With the increasing gap between demand for eye care and supply of ophthalmologists and optometrists, and the non-uniform distribution of eye care providers in US counties, barriers to eye examinations will likely increase. Telemedicine assessment of diabetic retinal disease through remote retinal imaging and diagnosis has the potential to meet these growing demands. To establish evidence for a telemedicine program as an effective modality for diabetic retinopathy (DR) assessment, the interpretation of teleretinal images should compare favorably with Early Treatment Diabetic Retinopathy Study film or digital photographs. We review the current evidence on the critical features and characteristics of ocular telehealth programs for DR in the following categories: image gradability, mydriasis, sensitivity and specificity, cost-effectiveness, long-term effectiveness, patient comfort and satisfaction, and improvement of patient related outcomes.
authors.affiliation: a Beetham Eye Institute, Joslin Diabetes Center , Boston , MA , USA.
authors.forename: Aditi
authors.initials: A
authors.lastname: Gupta
authors.affiliation: a Beetham Eye Institute, Joslin Diabetes Center , Boston , MA , USA.|b Department of Ophthalmology , Harvard Medical School , Boston , MA , USA.
authors.forename: Jerry
authors.initials: J
authors.lastname: Cavallerano
authors.affiliation: a Beetham Eye Institute, Joslin Diabetes Center , Boston , MA , USA.|b Department of Ophthalmology , Harvard Medical School , Boston , MA , USA.
authors.forename: Jennifer K
authors.initials: JK
authors.lastname: Sun
authors.affiliation: a Beetham Eye Institute, Joslin Diabetes Center , Boston , MA , USA.|b Department of Ophthalmology , Harvard Medical School , Boston , MA , USA.
authors.forename: Paolo S
authors.initials: PS
authors.lastname: Silva
mesh_terms: D003362:Cost-Benefit Analysis; D003930:Diabetic Retinopathy / Q000175:diagnosis*; D003952:Diagnostic Imaging / Q000191:economics / Q000379:methods; D019317:Evidence-Based Medicine; D006801:Humans; D017060:Patient Satisfaction; D010781:Photography / Q000191:economics / Q000379:methods; D012680:Sensitivity and Specificity; D017216:Telemedicine / Q000191:economics / Q000379:methods*
keywords: Diabetic macular edema; diabetic retinopathy; digital; remote; retinal imaging