In a Large Healthcare System in the Bronx, Teleretinal Triaging Was Found to Increase Screening and Healthcare Access for an Underserved Population with a High Incidence of T2DM and Retinopathy

Kevin Dahlan, Pamela Suman, David Rubaltelli, Anurag Shrivastava, Roy Chuck and Umar Mian ()
Additional contact information
Kevin Dahlan: Stony Brook Department of Ophthalmology, Stony Brook Medicine, Stony Brook, NY 11794, USA
Pamela Suman: Division of Infectious Disease, Department of Vaccine Center, NYU Langone Health Medical Center, New York, NY 10016, USA
David Rubaltelli: Department of Ophthalmology and Visual Sciences, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY 10467, USA
Anurag Shrivastava: Department of Ophthalmology and Visual Sciences, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY 10467, USA
Roy Chuck: Department of Ophthalmology and Visual Sciences, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY 10467, USA
Umar Mian: Department of Ophthalmology and Visual Sciences, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY 10467, USA

IJERPH, 2023, vol. 20, issue 7, 1-8

Abstract: The early treatment of diabetic retinopathy (DR) prevents vision-threatening proliferative retinopathy (PDR) and macular edema (DME). Our study evaluates telemedicine (teleretinal) screening for DR in an inner-city healthcare network with a high ethnic diversity and disease burden. Fundus photographs were obtained and graded in a centralized reading center between 2014 and 2016. Patients with positive screenings were referred to a retina specialist. An analysis of sensitivity and specificity and a subgroup analysis of prevalence, disease severity, and follow-up adherence were conducted. In 2251 patients, the ‘1-year’ and ‘Overall’ follow-ups were 35.1% and 54.8%, respectively. Severe grading, male gender, and age were associated with better follow-up compliance. The DR, PDR, and DME prevalence was 24.9%, 4.1%, and 5.9%, respectively, and was significantly associated with HbA1c. The sensitivity and specificity for DR, PDR, and DME were 70% and 87%, 87% and 75%, and 37% and 95%, respectively. No prevalence differences were noted between ethnicities. Annual diabetic eye exam adherence increased from 55% to 85% during the study period. Teleretinal triaging is sensitive and specific for DR and improved diabetic eye exam compliance for underserved populations when integrated into large healthcare networks. The adherence to follow-up recommendations was better among older patients and among those with more severe retinopathy.

Keywords: proliferative diabetic retinopathy; diabetic macular edema; telemedicine; teleretinal; fundus photography; diabetic retinopathy screening (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2023
References: View complete reference list from CitEc
Citations:

Downloads: (external link)
https://www.mdpi.com/1660-4601/20/7/5349/pdf (application/pdf)
https://www.mdpi.com/1660-4601/20/7/5349/ (text/html)

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:gam:jijerp:v:20:y:2023:i:7:p:5349-:d:1112693

Access Statistics for this article

IJERPH is currently edited by Ms. Jenna Liu

More articles in IJERPH from MDPI
Bibliographic data for series maintained by MDPI Indexing Manager ().