Telemedicine screening program for diabetic retinopathy in patients with type 1 diabetes mellitus

Endocrinol Diabetes Nutr (Engl Ed). 2023 Mar;70(3):196-201. doi: 10.1016/j.endien.2023.03.006.

Abstract

Purpose: To analyze the results of the telemedicine screening program for diabetic retinopathy (DR) in patients with type 1 diabetes conducted by the Endocrinology and Nutrition Management Unit of Virgen del Rocío University Hospital.

Methods: This cross-sectional study comprised patients with type 1 diabetes mellitus (DM) in our DR screening program from January 2018 to November 2020. Fundus photographs are performed by trained nurses and reviewed by a trained endocrinologist. Those suggestive of pathology are sent to ophthalmology through a telematic program for review.

Results: Of the 995 fundus photographs evaluated, 646 (65.3%) showed no evidence of DR, 327 (33.1%) presented possible DR, and 16 (1.6%) were not gradable. The diagnosis was confirmed in 254 patients after reviewing by ophthalmology, and the screening program achieved a positive predictive value for DR of 77.7%. Seventy-three were excluded by ophthalmology due to the absence of DR (false positive rate - 22.3%). In 92.5% of the cases classified by the ophthalmologist, the degree of DR was mild or very mild.

Conclusion: Our telemedicine screening program for DR in patients with type 1 DM is consistent with the literature. Effective screening for DR is performed, with patients diagnosed in the early stages. Telemedicine programs facilitate efficient communication among healthcare personnel.

Keywords: Cribado; Diabetes mellitus; Diabetic retinopathy; Fundus photographs; Retinografía; Retinopatía diabética; Screening; Telemedicina; Telemedicine.

MeSH terms

  • Cross-Sectional Studies
  • Diabetes Mellitus, Type 1* / complications
  • Diabetic Retinopathy* / diagnosis
  • Humans
  • Mass Screening / methods
  • Telemedicine* / methods