Virtual Visionaries: Teleophthalmology’s Breakthrough in Diabetic Retinopathy Treatment

Tilottama Basnet, B.Optom

Student, Achary Iinstitute of Allied Health Sciences, Bengaluru, India

 

The American Telemedicine Association defines telemedicine as the electronic transmission of medical data between sites with the goal of improving patient health. ⁽¹⁾  One area within this discipline that has great promise for raising the calibre and accessibility of eye care services is teleophthalmology. The incidence of diabetic retinopathy (DR), the primary cause of blindness in working-age people, is anticipated to increase significantly as the prevalence of diabetes mellitus (DM) is predicted to reach 642 million worldwide by 2040. ⁽²⁾

The Power of Early Detection and Routine Screening:

Diabetic retinopathy is the most prevalent vascular consequence of diabetes. Studies suggest that less than 10% of diabetics require therapy for vision threatening DR. Early identification and appropriate treatments are critical, necessitating lifelong regular retinal examinations. ⁽³⁾
Boucher et al. confirmed the reliability of telemedicine for DR screening. Teleophthalmology using digital retinal imaging increases DR detection rates, including curable cases, and prevents vision loss. Teleophthalmology has equal sensitivity and specificity to standard clinical evaluations (62.5%-98.2% and 76.6%-98.7%, respectively). ⁽⁴⁾

Bridging the Gap: Traditional Methods vs. Teleophthalmology

Teleophthalmology enhances accessibility and efficiency, but traditional eye care is required for complete therapy. Combining both techniques improves patient outcomes. Telemedicine DR screening has several advantages over traditional procedures, including reduced eye irritation, faster examinations, no pupil dilation, and more accessibility. ⁽³⁾
non-mydriatic fundus imaging is a very sensitive and specific method for screening mild to severe non-proliferative DR (NPDR). Perrier et al. discovered that employing two 45-degree non-mydriatic pictures resulted in 87.5% sensitivity and 92.3% specificity, with significantly better findings when using three or four images. ⁽⁵⁾

Enhancing Patient Satisfaction and Cost-Effectiveness

Guidelines for high-quality telemedicine-assisted diabetic retinopathy screening have been created by the American Telemedicine Association. The precision, dependability, and economy of teleophthalmology are enhanced by developments in imaging and communications. By avoiding pupil dilation and offering quicker, less intrusive tests, this technique increases patient satisfaction. ⁽⁶⁾ Another affordable option that lowers healthcare expenses and preserves excellent levels of service is teleophthalmology. ⁽⁷⁾

2,435 diabetic patients were tested utilising a non-retinal mydriatic camera and telemedicine as part of a study conducted by the Department of Ophthalmology at the University General Hospital of Alicante and Department of Primary Care of Alicante. The frequency of DR was shown to be 17.90%, with various levels of severity. The study emphasised the advantages of teleophthalmology for early diagnosis and treatment, as well as enhancing communication between primary and specialised care. ⁽⁸⁾

Overcoming Challenges and Maximizing Potential

Despite its benefits, teleophthalmology confronts several hurdles, including high initial capital investment expenses for fundus cameras and staff training. However, the long-term advantages for patient outcomes and healthcare efficiency are significant. ⁽⁹⁾ Teleophthalmology has shown to be a significant tool in meeting the growing need for diabetic retinopathy care. It combines high sensitivity and specificity with the ease of remote screening, making it a critical component of current healthcare strategy. ⁽⁷⁾

Conclusion: Teleophthalmology’s Bright Future

Teleophthalmology is a noteworthy development in the fight against diabetic retinopathy. This collaborative care approach leads to better patient outcomes by increasing accessibility and early identification. Teleophthalmology can guarantee that patients, wherever they may be, receive timely and effective care as technology develops and healthcare systems change. By incorporating teleophthalmology into regular treatment, patients’ vision will be retained, and the incidence of diabetic retinopathy will be considerably decreased in the future. ⁽⁷⁾

 

References:

1. ATA’s Standardized Telehealth Terminology and Policy Language for States on Medical Practice.
2. International Diabetes Federation. IDF diabetes atlas. International Diabetes Federation; 2015.
3. Fong DS, Aiello LP, Ferris FL, Klein R. Diabetic retinopathy. Vol. 27, Diabetes Care. 2004. p. 2540–53.
4. Boucher MC, Nguyen QT, Angioi K. Mass community screening for diabetic retinopathy using a nonmydriatic camera with telemedicine. Canadian Journal of Ophthalmology. 2005;40(6):734–42.
5. Gomez-Ulla F, Alonso F, Aibar B, Gonzalez F. A comparative cost analysis of digital fundus imaging and direct fundus examination for assessment of diabetic retinopathy. Telemedicine and e-Health. 2008 Nov 1;14(9):912–8.
6. Surendran TS, Raman R. Teleophthalmology in diabetic retinopathy. In: Journal of Diabetes Science and Technology. Diabetes Technology Society; 2014. p. 262–6.
7. Kalogeropoulos D, Kalogeropoulos C, Stefaniotou M, Neofytou M. The role of tele-ophthalmology in diabetic retinopathy screening. Vol. 13, Journal of Optometry. Spanish Council of Optometry; 2020. p. 262–8.
8. Martínez Rubio M, Moya Moya M, Bellot Bernabé A, Belmonte Martínez J. Diabetic retinopathy screening and teleophthalmology. Archivos de la Sociedad Española de Oftalmología (English Edition). 2012 Dec;87(12):392–5.
9. Salongcay RP, Silva PS. The role of teleophthalmology in the management of diabetic retinopathy. Vol. 7, Asia-Pacific Journal of Ophthalmology. Asia-Pacific Academy of Ophthalmology; 2018. p. 17–21.