92-OR: Increased Disease Detection, Yet Treatment Barriers Identified, with Point-of-Care Retinopathy Screening

Abstract

Due to limitations in access to specialized eye care, the majority of people with diabetic retinopathy (DR) are not screened routinely. To increase screening for DR, the Utah Diabetes and Endocrinology Center clinic began to offer point-of-care retinal image screening for patients with diabetes who had not had a dilated eye exam in the last year. Retinal photos obtained with a digital non-mydriatic camera were interpreted by a vitreoretinal specialist. From 11/2017 to 12/2020, 320 people underwent point-of-care DR screening. Of these, 298 (93%) had retinal images that were of sufficient quality. Mild-moderate DR was identified in 63 participants (21%), moderate-severe DR in 29 participants (10%) and proliferative DR in 11 participants (4%). Patients with advanced DR were referred for in-person evaluation. Five of 11 patients with proliferative DR visited a University of Utah (U of U) ophthalmologist compared to 9 of 29 patients with moderate-severe DR. Four of 14 patients with advanced retinopathy seen by U of U ophthalmology began retinopathy-specific treatment (anti-VEGF injection/ photocoagulation). We conclude that initiation of point-of-care retinal screening to patients not routinely followed by ophthalmologists increased detection of mild, moderate and proliferative DR. These findings also identify follow-up with retinal specialists after referral as a potential treatment barrier. Disclosure M. Wahl: None. J. Neuberger: None. M. L. Litchman: Research Support; Self; Abbott Diabetes. G. S. Adjei-poku: None. A. Fagerlin: None. M. Hartnett: None. S. Fisher: None.