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

Area of Science:

• Ophthalmology
• Medical Imaging
• Public Health

Background:

• Diabetic retinopathy (DR) screening is crucial for preventing vision loss in diabetic patients.
• Digital fundus imaging offers a scalable solution for widespread DR screening.
• Integrating screening into diabetes clinics (DCs) can improve patient access and adherence.

Purpose of the Study:

• To evaluate the utility of ophthalmologist-graded digital fundus imaging for detecting incidental pathological findings during diabetic retinopathy (DR) screening in diabetes clinics (DCs).

Main Methods:

• A "store-and-forward" teleretinography system was used, capturing two mydriatic fundus images per eye for 1,930 patients across 3,859 eyes.
• Images were graded by a retina specialist according to the UK Diabetic Eye Screening Programme guidelines.
• Data collected included best-corrected visual acuity and any incidental fundus abnormalities beyond DR.

Main Results:

• No adverse events related to mydriasis were reported.
• Out of 3,679 gradable eyes, 30.04% showed DR, and 3.42% had maculopathy.
• Other significant findings included hypertensive retinopathy (34.33%), glaucoma suspects (15.27%), and age-related macular degeneration (10.52%).

Conclusions:

• Teleretinography in DCs is a cost-effective method for DR screening.
• This approach effectively identifies a wide spectrum of fundus pathologies, similar to outpatient settings.
• Integrating digital imaging and specialist grading into DCs improves detection rates for various eye conditions.