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Operational Components of Telemedicine Programs for Diabetic Retinopathy

  • Microvascular Complications—Retinopathy (JK Sun and PS Silva, Section Editors)
  • Published:
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Abstract

Diabetic retinopathy is a leading cause of new-onset vision loss worldwide. Treatments supported by large clinical trials are effective in preserving vision, but many persons do not receive timely diagnosis and treatment of diabetic retinopathy, which is typically asymptomatic when most treatable. Telemedicine evaluation to identify diabetic retinopathy has the potential to improve access to care and improve outcomes, but incomplete implementation of published standards creates a risk to program utility and sustainability. In a prior article, we reviewed the literature regarding the impact of imaging device, number and size of retinal images, pupil dilation, type of image grader, and diagnostic accuracy on telemedicine assessment for diabetic retinopathy. This article reviews the literature regarding the impact of automated image grading, cost effectiveness, program standards, and quality assurance (QA) on telemedicine assessment of diabetic retinopathy. Telemedicine assessment of diabetic retinopathy has the potential to preserve vision, but greater attention to development and implementation of standards is needed to better realize its potential.

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Acknowledgments

The authors thank Rebecca A. Swift, Librarian Phoenix Indian Medical Center, for her valuable assistance in the search and retrieval of articles used in this review.

The opinions expressed in this paper are those of the authors and do not necessarily reflect the views of the Indian Health Service.

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Authors and Affiliations

  1. Joslin Vision Network—Indian Health Service Teleophthalmology Program, Phoenix, AZ, USA

    Mark B. Horton

  2. Beetham Eye Institute, Joslin Diabetes Center, Boston, MA, USA

    Paolo S. Silva, Jerry D. Cavallerano & Lloyd Paul Aiello

  3. Department of Ophthalmology, Harvard Medical School, Boston, MA, USA

    Paolo S. Silva, Jerry D. Cavallerano & Lloyd Paul Aiello

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  1. Mark B. Horton
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  2. Paolo S. Silva
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  3. Jerry D. Cavallerano
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  4. Lloyd Paul Aiello
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Correspondence to Mark B. Horton.

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Conflict of Interest

Mark B. Horton, Paolo S. Silva, and Jerry D. Cavallerano declare that they have no conflict of interest.

Lloyd Paul Aiello reports non-financial support from Optos; and Optos has loaned Joslin Diabetes Center imaging equipment.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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This article is part of the Topical Collection on Microvascular Complications—Retinopathy

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Horton, M.B., Silva, P.S., Cavallerano, J.D. et al. Operational Components of Telemedicine Programs for Diabetic Retinopathy. Curr Diab Rep 16, 128 (2016). https://doi.org/10.1007/s11892-016-0814-7

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