Saving sight in China and beyond: the Lifeline Express model

Area of Science:

• Ophthalmology
• Public Health
• Telemedicine

Background:

• Cataract and diabetic retinopathy are leading causes of global blindness.
• Lifeline Express (LEX) has a 20-year history of providing free cataract surgery in rural China.
• China faces a high prevalence of diabetes and prediabetes, increasing the risk of diabetic retinopathy.

Purpose of the Study:

• To describe the expansion of LEX services to include nationwide diabetic retinopathy screening.
• To evaluate the effectiveness of a telemedicine-enabled screening program for diabetic retinopathy in China.
• To present LEX's model as a potential solution for large-scale chronic disease screening.

Main Methods:

• Establishment of 29 Diabetic Retinopathy Screening Centres across China.
• Referral sources included hospitals, community outreach, and mobile vans with fundus cameras.
• Electronic transfer of fundus images for grading and use of WeChat for electronic medical reports.

Main Results:

• Between April 2014 and December 2016, 34,506 diabetic patients were screened.
• Diabetic retinopathy was identified in 27.2% (9,396) of screened patients.
• LEX leveraged mobile technology and popular messaging apps for efficient screening and reporting.

Conclusions:

• LEX's program aligns with China's 'Healthy China 2030 Plan' emphasizing early chronic disease screening.
• The telemedicine-enabled model demonstrates potential for scalable nationwide diabetic retinopathy screening.
• LEX's initiative extends beyond cataract surgery to address the growing threat of diabetic retinopathy, with potential for international collaboration.