Eye Disease in Patients with Diabetes Screened with Telemedicine.
BACKGROUND
Telemedicine with nonmydriatic cameras can detect not only diabetic retinopathy but also other eye disease.


OBJECTIVE
To determine the prevalence of eye diseases detected by telemedicine in a population with a high prevalence of minority and American Indian/Alaskan Native (AI/AN) ethnicities.


SUBJECTS AND METHODS
We recruited diabetic patients 18 years and older and used telemedicine with nonmydriatic cameras to detect eye disease. Two trained readers graded the images for diabetic retinopathy, age-related macular degeneration (ARMD), glaucomatous features, macular edema, and other eye disease using a standard protocol. We included both eyes for analysis and excluded images that were too poor to grade.


RESULTS
We included 820 eyes from 424 patients with 72.3% nonwhite ethnicity and 50.3% AI/AN heritage. While 283/424 (66.7%) patients had normal eye images, 120/424 (28.3%) had one disease identified; 15/424 (3.5%) had two diseases; and 6/424 (1.4%) had three diseases in one or both eyes. After diabetic retinopathy (104/424, 24.5%), the most common eye diseases were glaucomatous features (44/424, 10.4%) and dry ARMD (24/424, 5.7%). Seventeen percent (72/424, 17.0%) showed eye disease other than diabetic retinopathy.


CONCLUSIONS
Telemedicine with nonmydriatic cameras detected diabetic retinopathy, as well as other visually significant eye disease. This suggests that a diabetic retinopathy screening program needs to detect and report other eye disease, including glaucoma and macular disease.
['Park|Dong-Wouk|DW|', 'Mansberger|Steven L|SL|']
D000328:Adult D000368:Aged D003920:Diabetes Mellitus D003930:Diabetic Retinopathy D005128:Eye Diseases D005260:Female D006630:Hispanic or Latino D006801:Humans D007198:Indians, North American D008297:Male D008875:Middle Aged D009885:Ophthalmology D012815:Signal Processing, Computer-Assisted D017216:Telemedicine
telemedicine Ophthalmology e-health telehealth