Results of a New Virtual Program for Patients Overdue for Diabetic Retinopathy Evaluation

Abstract

Introduction: Diabetic retinopathy (DR) is one of the leading causes of preventable blindness in adults. Teleophthalmology for DR screening is becoming more prevalent; however, most programs are focused on baseline screening rather than screening and monitoring patients with established higher degrees of retinopathy. This study evaluated the incidence of detected ocular disease in a new virtual care program focused on assessing patients with a known history of retinopathy who were overdue for follow-up. Methods: A retrospective cohort study was performed on Kaiser Permanente Southern California patients with a prior diagnosis of DR who were at least 1 year overdue for their retinopathy assessment. The new virtual care program consisted of a scheduled technician visit where vision, intraocular pressure, macular optical coherence tomography (OCT), and ultrawide-field retinal photographs were taken and then remotely interpreted by a centralized clinical reading center. Patients who had a detected abnormality on imaging were referred to the clinic for further evaluation and management. Results: There were 790 patients enrolled in the program with an abnormality detected in 34.6% of patients. Of patients with a detected abnormality, 87.2% attended the recommended follow-up evaluation in the clinic. Concern for proliferative diabetic retinopathy (PDR) was the most common abnormality detected on imaging (10.3% of eyes). Treatments were administered to 27.2% of eyes that attended clinic evaluation following an abnormal screening result. Conclusion: Expanded teleophthalmology pathways can help achieve timely DR evaluation and increase access to care especially in vulnerable and medically underserved communities.