Using a Wide-View Digital Laser Ophthalmoscope to Increase Diabetic Retinopathy Screening Rates, Identify New Cases of Diabetic Retinopathy, Reduce No-Shows, and Create Opportunities for Research
- John G. Leiner, MD,
- Mohan M. Nadkarni, MD,
- Sara Aldridge, RN,
- John B. Schorling, MD and
- Joel M. Schectman, MD
Diabetic retinopathy is the leading cause of blindness in the United States for people aged 20-74 years. After 20 years of diabetes, almost all type 1 diabetic and > 60% of type 2 diabetic patients have retinopathy.
Diabetic retinopathy progresses from mild nonproliferative abnormalities to proliferative diabetic retinopathy (PDR), which is characterized by new blood vessel growth on the retina and on the posterior surface of the vitreous. Macular edema can develop at any stage. Once PDR or macular edema begins to occur, diabetic eye disease can become vision-threatening.1
Among those at high risk, annual examination and laser photocoagulation reduce the risk by 50%.2 However, it is estimated that, nationally, only ~ 20% of diabetic patients visit an ophthalmologist or other ophthalmological professional on a yearly basis as recommended by the American Diabetes Association (ADA). Screening rates are lower and retinopathy rates correspondingly higher among medically indigent, minority populations, or otherwise underserved groups.3,4
Program Description and Results
The University of Virginia (UVA) Health System's largest primary care clinic, University Medical Associates, serves > 2,500 patients with diabetes. Most have no health insurance or are of lower socioeconomic status. Although adherence to ADA retinal screening guidelines is a priority, actual screening rates …
