Five-year experience of tele-ophthalmology for diabetic retinopathy screening in a rural population.

Autor:	Rodríguez Villa S; Servicio de Oftalmología, Hospital Comarcal Jarrio, Coaña, Asturias, España. Electronic address: susanarodriguezvilla@gmail.com., Alonso Álvarez C; Hospital Comarcal Jarrio, Coaña, Asturias, España., de Dios Del Valle R; Hospital Comarcal Jarrio, Coaña, Asturias, España., Salazar Méndez R; Servicio de Oftalmología, Hospital Comarcal Jarrio, Coaña, Asturias, España., Cuesta García M; Servicio de Oftalmología, Hospital Comarcal Jarrio, Coaña, Asturias, España., Ruiz García MJ; Servicio de Oftalmología, Hospital Comarcal Jarrio, Coaña, Asturias, España., Cubillas Martín M; Servicio de Oftalmología, Hospital Comarcal Jarrio, Coaña, Asturias, España., Rodríguez Vazquez M; Servicio de Oftalmología, Hospital Comarcal Jarrio, Coaña, Asturias, España.
Jazyk:	English; Spanish; Castilian
Zdroj:	Archivos de la Sociedad Espanola de Oftalmologia [Arch Soc Esp Oftalmol] 2016 Sep; Vol. 91 (9), pp. 426-30. Date of Electronic Publication: 2016 Feb 18.
DOI:	10.1016/j.oftal.2016.01.023
Abstrakt:	Objective: To identify the prevalence and risk factors of diabetic retinopathy (DR) among rural inhabitants included in a tele-ophthalmology program. To analyse diagnostic accuracy among primary care physicians, concordance with ophthalmologists, and financial savings. Material and Methods: An observational randomised study was conducted on 394 patients included in a tele-ophthalmology program (from January 2010 to January 2015). An analysis was performed on the clinical characteristics, DR findings in retinography images, and correspondence between the request for a second interpretation by an ophthalmologist, and previously established criteria for it: presence of moderate to severe DR, vision loss, poor image quality and/or intraocular pressure >22mmHg. Statistical analysis was performed using the SPSS program (Student t and χ(2) tests). Results: DR prevalence was 12.1%. Patients with glycosylated haemoglobin values >7.68% or those treated with a combination of insulin and oral antidiabetic drugs showed a higher risk of DR (P<.05). 43.3% of patients correctly referred to ophthalmologists showed moderate to severe DR. Unnecessary referrals to specialists were improved from 91.7% in 2010 to 98.6% in 2014. It is estimated that the program has made a total saving of €152,550.45. Conclusions: Tele-ophthalmology programs are a useful tool in DR screening. Primary care physicians are able to distinguish patients who need specialist care, avoiding unnecessary referrals to ophthalmologists, and saving costs. (Copyright © 2016 Sociedad Española de Oftalmología. Published by Elsevier España, S.L.U. All rights reserved.)
Databáze:	MEDLINE
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