Telemedicine Screening of the Prevalence of Diabetic Retinopathy Among Type 2 Diabetic Filipinos in the Community

Abstract

Purpose: To determine the feasibility of telemedicine screening for diabetic retinopathy in a community setting and to determine the prevalence of diabetic retinopathy among Filipino patients with type 2 diabetes in the community. Study Design: Cross-sectional study among patients with type 2 diabetes in six community health centers in an urban city in the Philippines. Materials and methods: Subjects were examined from November 2018 to December 2018. A three-field non-mydriatic 45’ fundus photographs were taken for each patient and photographs were uploaded in cloud storage and read by a retina specialist in a tertiary hospital for assessment of diabetic retinopathy and grading of the fundus photographs. The results were sent back to local health centers. Results: A total of 387 eyes of 195 persons were examined. Overall, 288 out of 387 eyes (95.36%) had gradable quality fundus photo (grade 3 and higher) and did not need eye dilation. Prevalence of diabetic retinopathy among the respondents was 25.26% - 3.16% had mild diabetic retinopathy, 15.79% had moderate diabetic retinopathy, 3.68% had severe diabetic retinopathy, and 3.68% had proliferative diabetic retinopathy. Other fundus findings noted include hypertensive retinopathy glaucomatous optic nerve, age-related macular degeneration, posterior vitreous detachment, clinically significant macular edema, and epiretinal membrane. Conclusion: Due to the significant number of patients with diabetic retinopathy among type 2 diabetics in the community, telemedicine screening was a feasible alternative to dilated fundus examination and may be considered as part of the local health program to prevent blindness due to diabetes.