Hamish Dunn1,2, L Weerasinghe3, LG Papantoniou4, C Wah4,2, G Liew4,2,H Do4,2, AJ White4,2
Purpose: Early detection of diabetic retinopathy (DR) reduces preventable blindness, but difﬁculty accessing ophthalmic services delays presentation, especially for high-risk patients. This study aims to improve timely DR diagnosis by trialling two porta- ble screening devices; non-mydriatic cameras (NMC) and electroretinography (ERG), at hospital points-of-care (POC).
Methods: A cross-sectional, opportunistic screening pilot-was conducted in Hospital emergency depart- ments (ED), wards and High-Risk Foot Clinics. Par- ticipants were recruited if they had elevated blood glucose, HBA1c , or diabetic foot ulcers; and had no DR screening in the preceding 12 months.
Bilateral two-ﬁeld NMC photographs and ERG readings (RetinaVue-100 & ReteVAL, Welsch Allyn) were taken, with additional mydriatic photos as a reference standard. Results were uploaded to the electronic medical record, and subsequently graded by two medical retina specialists masked to clinical details.
Results: Twenty-eight patients (mean age:
62.9 years, 57% male) were recruited. 64% recorded abnormal ERG scores, with no readings acquired in 10.7%.
Of 24 patients with assessable photographs,
6 (25%) had vision-threatening DR, amongst 17 (70.8%) who had any DR. Four patients had no diagnostic quality photographs due to media opaci- ties, including three who recorded ERG scores indi- cating vision-threatening DR.
Conclusion: This pilot study highlights the utility of portable DR screening for high-risk populations at hospital-POC, successfully detecting high levels of vision-threatening DR. Integrating these technol- ogies into POC-settings is likely to increase the early detection and management of DR. These results will inform a larger screening study.