Purpose-To evaluate optical coherence tomography thickness of the macula in people with diabetes but minimal or no retinopathy and compare these findings with published normative data in the literature from subjects reported to have no retinal disease.Design-Cross-sectional study.• Setting: Multicenter, community-and university-based practices.• Study Population: 97 subjects with diabetes with no or minimal diabetic retinopathy and no central retinal thickening on clinical examination and a center point thickness ≤225 microns on a Stratus™ (Carl Zeiss Meditec, Dublin, CA) optical coherence tomography (Stratus OCT™).• Observation Procedures: Electronic-ETDRS best-corrected visual acuity, 7-field stereoscopic color fundus photographs, Stratus OCT™ fast macular scan.• Main Outcome Measures: Central subfield thickness measured on Stratus OCT™.Results-On average, central subfield thickness was 201 ± 22 microns. Central subfield thickness was significantly greater in retinas from men than retinas from women subjects (mean 209 ± 18 microns versus 194 ± 23 microns, P<0.001). After adjusting for gender, no additional factors were found to be significantly associated with central subfield thickness (P>0.10).Conclusions-Central subfield thicknesses on Stratus OCT™ in people with diabetes and minimal or no retinopathy are similar to thicknesses reported from a normative database of people without diabetes. Central subfield thickness is greater in men than in women, consistent with many, but not all, previous reports. Studies involving comparisons of retinal thickness to expected norms should consider different mean values for women and men.

Ocular telemedicine and telehealth have the potential to decrease vision loss from DR. Planning, execution, and follow-up are key factors for success. Telemedicine is complex, requiring the services of expert teams working collaboratively to provide care matching the quality of conventional clinical settings. Improving access and outcomes, however, makes telemedicine a valuable tool for our diabetic patients. Programs that focus on patient needs, consider available resources, define clear goals, promote informed expectations, appropriately train personnel, and adhere to regulatory and statutory requirements have the highest chance of achieving success.