Authors: Liang Shuting, Cai Yi, Bai Xiangli, Tong Qizhe, Deng Xun, Shi Xuan, Li Xiaoxin
Abstract [Download PDF] [Read Full Text]
Objective
To develop a remote diabetic retinopathy (DR) screening system and to evaluate the effectiveness of the screening system in community.
Methods
A cross-sectional study was carried out under the informed consent of subjects in Peking University People’s Hospital and Beijing Xicheng District Desheng Community Health Service Center from June 2015 to December 2016.A remote DR screening system was established in Peking University People’s Hospital and Beijing Xicheng District Desheng Community Health Service Center during June 2015 to December 2016.Based on non-mydriatic digital eye fundus camera photography and the internet transmission technology, anterior ocular segment and fundus images of 2 473 eyes from 1 355 community subjects with type 2 diabetes mellitus were transmitted from Beijing Xicheng District Desheng Community Health Service Center to the reading center of Peking University People’s Hospital, and the results were provided to the subjects after analysis, including visual examination, diagnosis and follow-up rate of the subjects, the agreement between remote screening system and conventional screening method was analyzed and compared.
Results
The visual acuities of the 2 473 eyes of 1 355 subjects were obtained by trained community physician, and the visual acuity was ≤0.05 in 103 eyes (4.2%), >0.05-0.3 in 780 eyes (31.5%), >0.3 in 1 590 eyes (64.3%). A good consistency was found in the diagnosis and grading of DR (Kappa value=0.895) and in diagnosis of macular disorder (Kappa value=0.763) between the remote screening system and conventional screening method.In addition, the diagnosis results of retinal photocoagulation were consistent between the two methods (Kappa value=1.000). The mean duration of the remote screening system for one subject was 10 minutes, which was shorter than 23 minutes of conventional screening method.The follow-up rate of remote screening system was 75.2%.
Conclusions
There is a high consistency in the DR diagnosis and evaluation between the remote non-mydriatic screening system and conventional screening method.The screening program with follow-up requests has a satisfying follow-up rate, which could meet the demand of DR screening.