Results of a New Virtual Program for Patients Overdue for Diabetic Retinopathy Evaluation.

introductionDiabetic retinopathy (DR) is one of the leading causes of preventable blindness in adults. Teleophthalmology for DR screening is becoming more prevalent; however, most programs are focused on baseline screening rather than screening and monitoring patients with established higher degrees of retinopathy. This study evaluated the incidence of detected ocular disease in a new virtual care program focused on assessing patients with a known history of retinopathy who were overdue for follow-up.

methodsA retrospective cohort study was performed on Kaiser Permanente Southern California patients with a prior diagnosis of DR who were at least 1 year overdue for their retinopathy assessment. The new virtual care program consisted of a scheduled technician visit where vision, intraocular pressure, macular optical coherence tomography (OCT), and ultrawide-field retinal photographs were taken and then remotely interpreted by a centralized clinical reading center. Patients who had a detected abnormality on imaging were referred to the clinic for further evaluation and management.

resultsThere were 790 patients enrolled in the program with an abnormality detected in 34.6% of patients. Of patients with a detected abnormality, 87.2% attended the recommended follow-up evaluation in the clinic. Concern for proliferative diabetic retinopathy (PDR) was the most common abnormality detected on imaging (10.3% of eyes). Treatments were administered to 27.2% of eyes that attended clinic evaluation following an abnormal screening result.

conclusionExpanded teleophthalmology pathways can help achieve timely DR evaluation and increase access to care especially in vulnerable and medically underserved communities.