The Primary Care-based Teleretinal Diabetic Retinopathy Screening Initiative

About the Program

Category: Health (Best in Category)

Year: 2014

Diabetic retinopathy is the leading cause of blindness among working-age adults in the United States, but blindness can be prevented in greater than 90% of cases by prompt laser therapy. Early detection and treatment can significantly lessen the burden of blindness caused by this disease. However, within the traditional ophthalmologic referral systems a majority of persons are not compliant with current American Academy of Ophthalmology screening guidelines, a number that is far greater in safety net communities. Teleretinal screening for diabetic retinopathy can create a more effective triage system for this population, allowing for the earlier detection of disease and increasing the ophthalmologist’s ability to provide prompt and crucial treatment. To date, a system-level implementation of teleretinal screening, including appropriate ophthalmic follow-up care and definitive treatment, in an urban medically underserved, or safety net, population the size of that served by Los Angeles County Department of Health Services (LAC DHS) has not been achieved. However, a 12-month pilot study produced exceptional outcomes, demonstrating that 1697 of 2732 (62.1%) patients screened had normal exams that required no immediate follow-up while 260 of 2732 (9.5%) patients required expedited referral. Thus, the LAC DHS Teleretinal Diabetic Retinopathy Screening Program is an innovative approach to improve clinical outcomes and decrease the backlog of diabetic patients with treatable disease slowly going blind while waiting for ophthalmic evaluation in LA County.