Nonmydriatic Retinal Image Review at Time of Endocrinology Visit Results in Short-Term HbA1c Reduction in Poorly Controlled Patients with Diabetic Retinopathy

Salti, Haytham I.; Cavallerano, Jerry D.; Salti, Nisreen; Jawhari, Dalida Jaafar; Haddad, Sandra; Sun, Jennifer K.; Salti, Ibrahim; Aiello, Lloyd Paul

doi:10.1089/tmj.2010.0180

Cited by 11 publications

(6 citation statements)

References 19 publications

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“…13 Studies suggest that when patients with diabetes received personalized discussions of their retinal images during an endocrinology visit, HbA1c over the following 3 months improved more than endocrinology evaluation alone. 14 …”

Section: Introductionmentioning

confidence: 99%

Assessing the Effect of Personalized Diabetes Risk Assessments During Ophthalmologic Visits on Glycemic Control

et al. 2015

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Importance-Optimization of glycemic control is critical to reduce diabetes related complications, but long-term success is challenging. Although vision loss is among the greatest fears of individuals with diabetes, comprehensive personalized diabetes education and risk assessments are not consistently employed in ophthalmology settings.Objective-To determine whether point-of-care measurement of HbA1c and personalized diabetes complication risk assessments performed during retinal ophthalmology visits improve glycemic control as assessed by HA1c.

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Section: Introductionmentioning

confidence: 99%

Assessing the Effect of Personalized Diabetes Risk Assessments During Ophthalmologic Visits on Glycemic Control

et al. 2015

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“…Some screening programs have employed primary care providers [52,53], optometrists [54] or endocrinologist [55] as graders after receiving training in reading fundus photos, but these providers are also quite time-constrained. Other screening programs, such as the UK program and the DigiScope system (20), have trained professional “graders” who work under the guidance of an ophthalmologist.…”

Section: American Telemedicine Association: Teleophthalmology Practicmentioning

confidence: 99%

“…In one study where patients underwent remote fundus photography and education, their HbA1c decreased by 1.61 points compared to patients undergoing standard endocrinology evaluation [55]. In another study, participation in the tele-ophthalmology program, which included discussion of results, an educational session, and care coordination was correlated with statistically significant improved HbA1c and low-density lipoprotein levels [69].…”

Section: American Telemedicine Association: Teleophthalmology Practicmentioning

confidence: 99%

Telemedicine and Diabetic Retinopathy: Review of Published Screening Programs

Tozer

Woodward

Newman-Casey

2015

JED

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Background Diabetic Retinopathy (DR) is a leading cause of blindness worldwide even though successful treatments exist. Improving screening and treatment could avoid many cases of vision loss. However, due to an increasing prevalence of diabetes, traditional in-person screening for DR for every diabetic patient is not feasible. Telemedicine is one viable solution to provide high-quality and efficient screening to large number of diabetic patients. Purpose To provide a narrative review of large DR telemedicine screening programs. Methods Articles were identified through a comprehensive search of the English-language literature published between 2000 and 2014. Telemedicine screening programs were included for review if they had published data on at least 150 patients and had available validation studies supporting their model. Screening programs were then categorized according to their American Telemedicine Association Validation Level. Results Seven programs from the US and abroad were identified and included in the review. Three programs were Category 1 programs (Ophdiat, EyePacs, and Digiscope), two were Category 2 programs (Eye Check, NHS Diabetic Eye Screening Program), and two were Category 3 programs (Joslin Vision Network, Alberta Screening Program). No program was identified that claimed category 4 status. Programs ranged from community or city level programs to large nationwide programs including millions of individuals. The programs demonstrated a high level of clinical accuracy in screening for DR. There was no consensus amongst the programs regarding the need for dilation, need for stereoscopic images, or the level of training for approved image graders. Conclusion Telemedicine programs have been clinically validated and successfully implemented across the globe. They can provide a high-level of clinical accuracy for screening for DR while improving patient access in a cost-effective and scalable manner.

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“…[10][11][12] Teleophthalmology assessments are being widely studied in the U.S., [13][14][15][16][17] with a particular emphasis on primary care or endocrinology offices as the site of photo acquisition, [18][19][20][21][22][23] which may help improve systemic management. 24 Tele-ophthalmology may also be a way to control provider, payer, and societal costs. Depending on the structure of the intervention, a tele-ophthalmology assessment may prevent a separate physician encounter, pupillary dilation, and the associated travel and lost work time.…”

Section: Introductionmentioning

confidence: 99%

Tele-ophthalmology Screening for Proliferative Diabetic Retinopathy in Urban Primary Care Offices: An Economic Analysis

Brady¹,

Villanti²,

Gupta³

et al. 2014

Ophthalmic Surg Lasers Imaging Retina

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Nonmydriatic Retinal Image Review at Time of Endocrinology Visit Results in Short-Term HbA1c Reduction in Poorly Controlled Patients with Diabetic Retinopathy

Abstract: Nonmydriatic imaging and discussion of retinal findings during an endocrinologist visit may contribute, at least in the short term, to improved glycemic control in patients with DR and elevated HbA1c.

Cited by 11 publications

References 19 publications

Assessing the Effect of Personalized Diabetes Risk Assessments During Ophthalmologic Visits on Glycemic Control

Assessing the Effect of Personalized Diabetes Risk Assessments During Ophthalmologic Visits on Glycemic Control

Telemedicine and Diabetic Retinopathy: Review of Published Screening Programs

Tele-ophthalmology Screening for Proliferative Diabetic Retinopathy in Urban Primary Care Offices: An Economic Analysis

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