Abstract
Diabetic eye disease is the most common cause of new cases of blindness in the Western world. If the disease is detected early then proper treatment can be provided to prevent loss of vision. Regular screening can reduce the incidence and prevalence of blindness due to diabetic retinopathy. Health personnel, optometrists and primary care providers can perform the screening using digital nonmydriatic fundus cameras. Digital data can be archived, stored, manipulated and sent via telecommunication networks, e.g. the Internet, to ophthalmologists for diagnosis and second opinions.
Easy-to-operate, low cost and portable digital fundus cameras and intuitive software are necessary to perform cost-effective screening of rural, remote and underserved communities using trained lay personnel. Several feasibility studies of telemedicine screening for diabetic retinopathy have been reported. These studies demonstrate the enormous usefulness of this technology for communities living in rural and remote areas. Further studies are needed to prove the cost benefit of telemedicine technology for diabetic retinopathy screening.
Similar content being viewed by others
References
King H, Aubert RE, Herman WH. Global burden of diabetes, 1995–2025: prevalence, numerical estimates, and projections. Diabetes Care 1998; 21(9): 1414–31.
American Diabetes Association. Diabetes facts and figures. Available from URL: http://www.diabetes.org [Accessed 2002 Sep 4].
Ferris III FL. How effective are treatments for diabetic retinopathy? JAMA 1993; 269(10): 1290–1.
Stefansson E, Bek T, Prota M, et al. Screening and prevention of diabetic blindness. Acta Ophthalmol Scand 2000; 78: 374–85.
Witkin SR, Klein R. Ophthalmologic care for persons with diabetes. JAMA 1984; 251(19): 2534–7.
McCarty CA, Lloyd-Smith CW, Lee SE, et al. Use of eye care services by people with diabetes: the Melbourne Visual Impairment Project. Br J Ophthalmol 1998; 82(4): 410–4.
National Health and Medical Research Council. Management of diabetic retinopathy: clinical practice guidelines. Canberra: Mational Health and Medical Research Council, 1997.
Taylor HR, Keeffe JE. World blindness: a 21st century perspective. Br J Ophthalmol 2001; 85(3): 261–6.
Javitt JC, Canner JK, Frank RG, et al. Detecting and treating retinopathy in patients with type I diabetes mellitus: a health policy model. Ophthalmology 1990; 97(4): 483–94.
Pandit RJ, Taylor R. Mydriasis and glaucoma: exploding the myth: a systematic review. Diabet Med 2000; 17(10): 693–9.
Klein R. Retinopathy and other ocular complications in diabetes. In: Olefsky JM, Sherwin RS, editors. Diabetic mellitus: management and complications. New York (NY): Churchill Livingstone, 1985: 101–58.
Lee V, Kingsley RM, Lee ET, et al. The diagnosis of diabetic retinopathy: ophthalmoscopy versus fundus photography. Ophthalmology 1993; 100: 1504–12.
Williams R, Nussey S, Humphry R, et al. Assessment of non-mydriatic fundus photography in detection of diabetic retinopathy. BMJ 1986; 293: 1140–3.
Yogesan K, Constable IJ, Eikelboom RH, et al. Tele-ophthalmic screening using digital imaging devices. Aust N Z J Ophthalmol 1998; 26 Suppl. 1: 9–11.
Constable IJ, Yogesan K, Eikelboom RH, et al. Digital screening for eye disease. Clin Exp Ophthalmol 2000; 28: 129–32.
Williamson TH, Keating D. Telemedicine and computers in diabetic retinopathy screening. Br J Ophthalmol 1998; 82: 5–7.
Lee P. Telemedicine: opportunities and challenges for the remote care of diabetic retinopathy. Arch Ophthalmol 1999; 117: 1639–40.
Diamond JP, McKinnon M, Barry C, et al. Non-mydriatic fundus photography: a viable alternative to funduscopy for identification of diabetic retinopathy in an Aboriginal population in rural Western Australia? Aust N Z J Ophthalmol 1998; 26: 109–15.
Young S, George J, Lusty J, et al. A new screening tool for diabetic retinopathy: the Canon CR5 45NM retinal camera with Frost Medical Software RIS-Lite digital imaging system. J Audiov Media Med 1997; 20: 11–4.
Lim JI, LaBree L, Nicholos T, et al. A comparison of digital nonmydriatic fundus imaging with standard 35-millimeter slides for diabetic retinopathy. Ophthalmology 2000; 107: 866–70.
Yogesan K, Constable IJ, Barry CJ, et al. Telemedicine screening of diabetic retinopathy using hand-held fundus camera. Telemed J 2000; 6(2): 231–5.
Constable IJ, Yogesan K, Eikelboom RH, et al. Digital screening for eye disease. Clin Exp Ophthalmol 2000; 28: 129–32.
Bursell SE, Cavallerano JD, Cavallerano AA, et al. Stereo nonmydriatic digital-video color retinal imaging compared with early treatment diabetic retinopathy study seven standard field 355-mm stereo color photos for determining level of diabetic retinopathy. Ophthalmology 2001; 108: 572–85.
Tennant MTS, Rudnisky CJ, Hinz BJ, et al. Tele-ophthalmology via stereoscopic digital imaging: a pilot study. Diabet Technol Ther 2000; 2(4): 583–7.
Cummings DM, Morrissey S, Barondes MJ, et al. Screening for diabetic retinopathy in rural areas: the potential of telemedicine. J Rural Health 2001; 17(1): 25–31.
Marcus DM, Brooks SE, Ulrich LD, et al. Telemedicine diagnosis of eye disorders by direct ophthalmoscopy: a pilot study. Ophthalmology 1998; 105(10): 1907–14.
Liesenfeld B, Kohner E, Piehlmeier W, et al. A telemedical approach to the screening of diabetic retinopathy: digital fundus photography. Diabetes Care 2000; 23(3): 345–8.
Aoki N, Li HK, Dunn K, et al. Cost effectiveness of teleophthalmology for screening and follow up of diabetic retinopathy in a prison inmate population [abstract]. Telemed J 2000; 6: 85.
Tang RA, Appel D, Caswell H, et al. Managing eye disease behind bars: how we handle consultations and referral screening triage [abstract]. Telemed J 2000; 6: 188.
Barry CJ, Henderson C, Kanagasingam Y, et al. Working towards a portable tele-ophthalmic system for use in maximum security prisons: a pilot study. Telemed J E Health 2001; 7(3): 1–5.
Yogesan K, Henderson C, Barry CJ, et al. Online eye care in prisons in Western Australia. J Telemed Telecare 2001; 7 Suppl. 2: 63–4.
Sjakon GT, Yudianto A. Benefits of using digital images and the internet for conducting ophthalmic consultations between Indonesia and Australia. J Ophthalmic Photo 2000; 22(2): 62–3.
Yogesan K, Constable IJ. Online eye care. Ophthalmology. In press.
Acknowledgements
No sources of funding were used to assist in the preparation of this manuscript. The authors have no conflicts of interest that are directly relevant to the content of this manuscript.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Yogesan, K., Constable, I.J. & Chan, I. Telemedicine Screening for Diabetic Retinopathy. Dis-Manage-Health-Outcomes 10, 673–678 (2002). https://doi.org/10.2165/00115677-200210110-00001
Published:
Issue Date:
DOI: https://doi.org/10.2165/00115677-200210110-00001