title: Operational Components of Telemedicine Programs for Diabetic Retinopathy.
abstract: Diabetic retinopathy is a leading cause of new-onset vision loss worldwide. Treatments supported by large clinical trials are effective in preserving vision, but many persons do not receive timely diagnosis and treatment of diabetic retinopathy, which is typically asymptomatic when most treatable. Telemedicine evaluation to identify diabetic retinopathy has the potential to improve access to care and improve outcomes, but incomplete implementation of published standards creates a risk to program utility and sustainability. In a prior article, we reviewed the literature regarding the impact of imaging device, number and size of retinal images, pupil dilation, type of image grader, and diagnostic accuracy on telemedicine assessment for diabetic retinopathy. This article reviews the literature regarding the impact of automated image grading, cost effectiveness, program standards, and quality assurance (QA) on telemedicine assessment of diabetic retinopathy. Telemedicine assessment of diabetic retinopathy has the potential to preserve vision, but greater attention to development and implementation of standards is needed to better realize its potential.
authors: Joslin Vision Network-Indian Health Service Teleophthalmology Program, Phoenix, AZ, USA. mark.horton@ihs.gov.
authors: Mark B
authors: MB
authors: Horton
authors: Beetham Eye Institute, Joslin Diabetes Center, Boston, MA, USA.|Department of Ophthalmology, Harvard Medical School, Boston, MA, USA.
authors: Paolo S
authors: PS
authors: Silva
authors: Beetham Eye Institute, Joslin Diabetes Center, Boston, MA, USA.|Department of Ophthalmology, Harvard Medical School, Boston, MA, USA.
authors: Jerry D
authors: JD
authors: Cavallerano
authors: Beetham Eye Institute, Joslin Diabetes Center, Boston, MA, USA.|Department of Ophthalmology, Harvard Medical School, Boston, MA, USA.
authors: Lloyd Paul
authors: LP
authors: Aiello
mesh_terms: D003362:Cost-Benefit Analysis; D003930:Diabetic Retinopathy / Q000628:therapy*; D006801:Humans; D011785:Quality Assurance, Health Care; D017216:Telemedicine / Q000379:methods*
keywords: Diabetes mellitus; Diabetic retinopathy; Telemedicine; Teleophthalmology