Tele-ophthalmology: Diabetic Retinopathy Imaging in a Correctional Care Environment ? A Store-and Forward Non-mydriatic Digital Camera Remote Care Study Preliminary Analysis

Author: Minh D. Dang, BA

Primary Advisor: Craig Johnson, PhD

Committee Members: Helen K. Li, MD (co-author) (UT Houston Medical Branch); Sami Uwaydat, MD (co-author) (UT Houston Medical Branch)

Masters thesis, The University of Texas School of Health Information Sciences at Houston.

Objective (s): Implement a store-and-forward non-mydriatic digital camera for telemedicine screening and evaluation of diabetic retinopathy in a remote prison population. Materials and methods: The Topcon Non-mydriatic Imagenet 2000 Lite system captured undilated digital photographs of both eyes of diabetics housed at Huntsville's Ellis and Estelle prison units. The digital images (TIFF's) were transferred via a partial T1 line to a 200-GB UTMB server for later evaluation. The reading ophthalmologist reviewed the images on a second Topcon system at UTMB and evaluated for diabetic retinopathy. Questionnaires were used to collect inmate demographic information and assess patient and primary care provider acceptance of telemedicine as an alternative eye care delivery method. Results: One hundred and seventy-one of a possible 226 diabetic inmates were imaged. Only one of the imaged was female. Thirty-four percent had some signs of diabetic retinopathy and 40^^25 had never undergone a recommended dilated retinal exam. Twenty-three inmates were referred and schedule for examination at UTMB Galveston. Acceptance of the telemedicine system for inmates and primary care providers was 93^^25 and 100^^25, respectively. Conclusions: Vision threatening diabetic retinopathy was identified with nonmydriatic digital photography. Questionnaires recorded high levels of acceptance from patient and primary care providers for telemedicine as an alternative mode of eye care delivery. A telemedicine non-mydriatic digital imaging system was shown to be an effective screening and evaluation tool for remote diagnosis of diabetic retinopathy.