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Diabetic retinopathy screening in urban primary care setting with a handheld smartphone-based retinal camera.
- Source :
-
Acta diabetologica [Acta Diabetol] 2020 Dec; Vol. 57 (12), pp. 1493-1499. Date of Electronic Publication: 2020 Aug 04. - Publication Year :
- 2020
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Abstract
- Aims: To evaluate diabetic retinopathy (DR) screening with a portable handheld smartphone-based retinal camera and telemedicine in an urban primary healthcare setting and to evaluate the learning curve for image acquisition, performed by healthcare personnel without previous experience in retinal imaging.<br />Methods: This was a prospective study that enrolled patients with type 2 diabetes mellitus (T2DM) followed at a primary healthcare unit in São Paulo, Brazil. After a brief training in image acquisition, there was further continuous feedback given by a retina specialist during the remote image reading process. Each patient underwent two fundus and one anterior ocular segment images per eye, after mydriasis. Patients were classified according to the need of referral.<br />Results: A total of 627 adult individuals with T2DM underwent retinal evaluation. The population was composed by 63.2% female individuals, age median of 66 years, diabetes duration 10.7 ± 8.2 years and HbA1c 7.7 ± 1.9% (61 + 20.8 mmol/mol). The most prevalent associated comorbidities were arterial hypertension (80.3%) and dyslipidemia (50.2%). Referral decision was possible in 81.2% patients. Most patients had absent or non-referable DR; the main ocular media opacity detected was cataract. After the 7th day of image acquisition, the daily rate of patients whose images allowed clinical decision was maintained above 80%. A higher HbA1c was associated with referable DR.<br />Conclusions: A low-cost DR screening strategy with a handheld device and telemedicine is feasible and has the potential to increase coverage of DR screening in underserved areas; the possibility of mobile units is relevant for DR screening in the context of COVID-19 pandemic. Daily rate of patients whose examinations allowed clinical decision. X-axis: day of examination; Y-axis: rate (%) of patients whose examinations allowed a clinical decision.
- Subjects :
- Adult
Aged
Brazil
COVID-19
Coronavirus Infections epidemiology
Diabetes Mellitus, Type 2 complications
Diabetic Retinopathy diagnostic imaging
Female
Humans
Male
Mass Screening instrumentation
Middle Aged
Pandemics
Pneumonia, Viral epidemiology
Prevalence
Primary Health Care methods
Prospective Studies
Referral and Consultation
Smartphone
Telemedicine instrumentation
Diabetic Retinopathy diagnosis
Mass Screening methods
Photography methods
Retina diagnostic imaging
Telemedicine methods
Subjects
Details
- Language :
- English
- ISSN :
- 1432-5233
- Volume :
- 57
- Issue :
- 12
- Database :
- MEDLINE
- Journal :
- Acta diabetologica
- Publication Type :
- Academic Journal
- Accession number :
- 32748176
- Full Text :
- https://doi.org/10.1007/s00592-020-01585-7