Why Miss the Chance? Incidental Findings while Telescreening for Diabetic Retinopathy

ABSTRACT

Purpose

To report on incidental pathological findings met while screening for Diabetic Retinopathy (DR) in Diabetes Clinics (DC) by ophthalmologist-graded digital fundus imaging.

Methods

At the DC of Pescara (central Italy), for 3,859 eyes of 1,930 consecutive patients having not undergone fundus examination in the last year, two mydriatic fundus digital images, taken with a CenterVue DRS Digital Retinal Camera, were sent along with Best Corrected Visual Acuity, on a “store-and-forward” basis, to an ophthalmologist trained in DR screening, and graded according to the UK Diabetic Eye Screening Programme. Incidental fundus abnormalities other than DR were reported.

Results

No adverse event to mydriasis was reported. One hundred and eighty eyes (4.66%) were ungradable. Among the 3,679 gradable ones, 1,105 (30.04%) showed different degrees of DR (R1 to R3), and 126 (3.42%) maculopathy (M1). Any Age-Related Macular Degeneration was present in 387 eyes (10.52%), any optic disc and parapapillary area features suspect for glaucoma in 562 eyes (15.27%), any hypertensive retinopathy in 1,263 eyes (34.33%), vitreoretinal interface disease in 252 eyes (6.84%), myopic choroidopathy in 92 eyes (2.50%), disc pallor in 31 eyes (0.84%). Mean time was 5 min for screening, 2 min for grading.

Conclusion

Teleretinography is a well-established, cost-effective procedure in DR screening. Along with increased attendance, locating a digital camera in a DC with a retina-specialist grader results in finding fundus pathologies also beyond DR, very similarly to fundus examination in an outpatient ophthalmic setting.

KEYWORDS:

• Telemedicine
• teleretinography
• fundus imaging
• diabetic retinopathy
• age-related macular degeneration
• glaucoma
• vitreoretinal interface disease

Declaration of interest statement

None of the authors have whatsoever financial interest in this study.

Financial support

No financial support was provided.

Disclosure of interest

None of the authors have any proprietary interest or conflict of interest related to this submission.

Publication elsewhere

This submission has not been published elsewhere previously and is not simultaneously being considered for any other publication.