Diabetes eye screening in urban settings serving minority populations

Detection of diabetic retinopathy and other ocular findings using telemedicine

Innovative Network for Sight (INSIGHT) Research Group

Research output: Contribution to journalArticle

Abstract

IMPORTANCE The use of a nonmydriatic camera for retinal imaging combined with the remote evaluation of images at a telemedicine reading center has been advanced as a strategy for diabetic retinopathy (DR) screening, particularly among patients with diabetes mellitus from ethnic/racial minority populations with low utilization of eye care. OBJECTIVE To examine the rate and types of DR identified through a telemedicine screening program using a nonmydriatic camera, as well as the rate of other ocular findings. DESIGN, SETTING, AND PARTICIPANTS A cross-sectional study (Innovative Network for Sight [INSIGHT]) was conducted at 4 urban clinic or pharmacy settings in the United States serving predominantly ethnic/racial minority and uninsured persons with diabetes. Participants included persons aged 18 years or older who had type 1 or 2 diabetes mellitus and presented to the community-based settings. MAIN OUTCOMES AND MEASURES The percentage of DR detection, including type of DR, and the percentage of detection of other ocular findings. RESULTS A total of 1894 persons participated in the INSIGHT screening program across sites, with 21.7%having DR in at least 1 eye. The most common type of DR was background DR, which was present in 94.1%of all participants with DR. Almost half (44.2%) of the sample screened had ocular findings other than DR; 30.7%of the other ocular findings were cataract. CONCLUSIONS AND RELEVANCE In a DR telemedicine screening program in urban clinic or pharmacy settings in the United States serving predominantly ethnic/racial minority populations, DR was identified on screening in approximately 1 in 5 persons with diabetes. The vast majority of DR was background, indicating high public health potential for intervention in the earliest phases of DR when treatment can prevent vision loss. Other ocular conditions were detected at a high rate, a collateral benefit of DR screening programs that may be underappreciated.

Original languageEnglish (US)
Pages (from-to)174-181
Number of pages8
JournalJAMA Ophthalmology
Volume133
Issue number2
DOIs
StatePublished - Feb 1 2015

Fingerprint

Telemedicine
Diabetic Retinopathy
Population
Type 1 Diabetes Mellitus
Cataract
Type 2 Diabetes Mellitus
Reading
Diabetes Mellitus

ASJC Scopus subject areas

  • Ophthalmology
  • Medicine(all)

Cite this

Diabetes eye screening in urban settings serving minority populations : Detection of diabetic retinopathy and other ocular findings using telemedicine. / Innovative Network for Sight (INSIGHT) Research Group.

In: JAMA Ophthalmology, Vol. 133, No. 2, 01.02.2015, p. 174-181.

Research output: Contribution to journalArticle

@article{75eeae2d849847c9b7a2e5b48db22e4f,
title = "Diabetes eye screening in urban settings serving minority populations: Detection of diabetic retinopathy and other ocular findings using telemedicine",
abstract = "IMPORTANCE The use of a nonmydriatic camera for retinal imaging combined with the remote evaluation of images at a telemedicine reading center has been advanced as a strategy for diabetic retinopathy (DR) screening, particularly among patients with diabetes mellitus from ethnic/racial minority populations with low utilization of eye care. OBJECTIVE To examine the rate and types of DR identified through a telemedicine screening program using a nonmydriatic camera, as well as the rate of other ocular findings. DESIGN, SETTING, AND PARTICIPANTS A cross-sectional study (Innovative Network for Sight [INSIGHT]) was conducted at 4 urban clinic or pharmacy settings in the United States serving predominantly ethnic/racial minority and uninsured persons with diabetes. Participants included persons aged 18 years or older who had type 1 or 2 diabetes mellitus and presented to the community-based settings. MAIN OUTCOMES AND MEASURES The percentage of DR detection, including type of DR, and the percentage of detection of other ocular findings. RESULTS A total of 1894 persons participated in the INSIGHT screening program across sites, with 21.7{\%}having DR in at least 1 eye. The most common type of DR was background DR, which was present in 94.1{\%}of all participants with DR. Almost half (44.2{\%}) of the sample screened had ocular findings other than DR; 30.7{\%}of the other ocular findings were cataract. CONCLUSIONS AND RELEVANCE In a DR telemedicine screening program in urban clinic or pharmacy settings in the United States serving predominantly ethnic/racial minority populations, DR was identified on screening in approximately 1 in 5 persons with diabetes. The vast majority of DR was background, indicating high public health potential for intervention in the earliest phases of DR when treatment can prevent vision loss. Other ocular conditions were detected at a high rate, a collateral benefit of DR screening programs that may be underappreciated.",
author = "{Innovative Network for Sight (INSIGHT) Research Group} and Cynthia Owsley and Gerald McGwin and Lee, {David J.} and Lam, {Byron L.} and Friedman, {David S} and Gower, {Emily W.} and Haller, {Julia A.} and Hark, {Lisa A.} and Jinan Saaddine",
year = "2015",
month = "2",
day = "1",
doi = "10.1001/jamaophthalmol.2014.4652",
language = "English (US)",
volume = "133",
pages = "174--181",
journal = "JAMA Ophthalmology",
issn = "2168-6165",
publisher = "American Medical Association",
number = "2",

}

TY - JOUR

T1 - Diabetes eye screening in urban settings serving minority populations

T2 - Detection of diabetic retinopathy and other ocular findings using telemedicine

AU - Innovative Network for Sight (INSIGHT) Research Group

AU - Owsley, Cynthia

AU - McGwin, Gerald

AU - Lee, David J.

AU - Lam, Byron L.

AU - Friedman, David S

AU - Gower, Emily W.

AU - Haller, Julia A.

AU - Hark, Lisa A.

AU - Saaddine, Jinan

PY - 2015/2/1

Y1 - 2015/2/1

N2 - IMPORTANCE The use of a nonmydriatic camera for retinal imaging combined with the remote evaluation of images at a telemedicine reading center has been advanced as a strategy for diabetic retinopathy (DR) screening, particularly among patients with diabetes mellitus from ethnic/racial minority populations with low utilization of eye care. OBJECTIVE To examine the rate and types of DR identified through a telemedicine screening program using a nonmydriatic camera, as well as the rate of other ocular findings. DESIGN, SETTING, AND PARTICIPANTS A cross-sectional study (Innovative Network for Sight [INSIGHT]) was conducted at 4 urban clinic or pharmacy settings in the United States serving predominantly ethnic/racial minority and uninsured persons with diabetes. Participants included persons aged 18 years or older who had type 1 or 2 diabetes mellitus and presented to the community-based settings. MAIN OUTCOMES AND MEASURES The percentage of DR detection, including type of DR, and the percentage of detection of other ocular findings. RESULTS A total of 1894 persons participated in the INSIGHT screening program across sites, with 21.7%having DR in at least 1 eye. The most common type of DR was background DR, which was present in 94.1%of all participants with DR. Almost half (44.2%) of the sample screened had ocular findings other than DR; 30.7%of the other ocular findings were cataract. CONCLUSIONS AND RELEVANCE In a DR telemedicine screening program in urban clinic or pharmacy settings in the United States serving predominantly ethnic/racial minority populations, DR was identified on screening in approximately 1 in 5 persons with diabetes. The vast majority of DR was background, indicating high public health potential for intervention in the earliest phases of DR when treatment can prevent vision loss. Other ocular conditions were detected at a high rate, a collateral benefit of DR screening programs that may be underappreciated.

AB - IMPORTANCE The use of a nonmydriatic camera for retinal imaging combined with the remote evaluation of images at a telemedicine reading center has been advanced as a strategy for diabetic retinopathy (DR) screening, particularly among patients with diabetes mellitus from ethnic/racial minority populations with low utilization of eye care. OBJECTIVE To examine the rate and types of DR identified through a telemedicine screening program using a nonmydriatic camera, as well as the rate of other ocular findings. DESIGN, SETTING, AND PARTICIPANTS A cross-sectional study (Innovative Network for Sight [INSIGHT]) was conducted at 4 urban clinic or pharmacy settings in the United States serving predominantly ethnic/racial minority and uninsured persons with diabetes. Participants included persons aged 18 years or older who had type 1 or 2 diabetes mellitus and presented to the community-based settings. MAIN OUTCOMES AND MEASURES The percentage of DR detection, including type of DR, and the percentage of detection of other ocular findings. RESULTS A total of 1894 persons participated in the INSIGHT screening program across sites, with 21.7%having DR in at least 1 eye. The most common type of DR was background DR, which was present in 94.1%of all participants with DR. Almost half (44.2%) of the sample screened had ocular findings other than DR; 30.7%of the other ocular findings were cataract. CONCLUSIONS AND RELEVANCE In a DR telemedicine screening program in urban clinic or pharmacy settings in the United States serving predominantly ethnic/racial minority populations, DR was identified on screening in approximately 1 in 5 persons with diabetes. The vast majority of DR was background, indicating high public health potential for intervention in the earliest phases of DR when treatment can prevent vision loss. Other ocular conditions were detected at a high rate, a collateral benefit of DR screening programs that may be underappreciated.

UR - http://www.scopus.com/inward/record.url?scp=84922901040&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84922901040&partnerID=8YFLogxK

U2 - 10.1001/jamaophthalmol.2014.4652

DO - 10.1001/jamaophthalmol.2014.4652

M3 - Article

VL - 133

SP - 174

EP - 181

JO - JAMA Ophthalmology

JF - JAMA Ophthalmology

SN - 2168-6165

IS - 2

ER -