Follow-Up Compliance for Patients Diagnosed with Diabetic Retinopathy After Teleretinal Imaging in Primary Care

Background: Teleretinal imaging has been demonstrated to increase diabetic patient compliance with annual retinal examinations, but few studies have examined patient behavior after screening. Compliance with eye specialist follow-up is critical to ensure remote detection programs improve long-term vision outcomes for patients with diabetes.

Introduction: The purpose of this study was to assess the rate of eye specialist follow-up compliance after referral for diabetic retinopathy (DR) from a teleretinal imaging program in a large primary care group practice.

Materials and Methods: This is a retrospective chart review study of patients examined through a teleretinal imaging program between June 2015 and October 2017. Data from an electronic medical record were used to determine whether patients who were referred for management of DR requiring treatment attended follow-up eye care appointments. Reasons for nonattendance were also identified.

Results: During the study time period, there were 110 patients referred for detected vision-threatening DR. Of those patients, 62 (56.3%) had an eye examination within 3 months, 83 (75.5%) had an examination within 1 year, and 92 (83.6%) had an examination within the 30-month study period. Of the patients who had follow-up eye examinations, 62.7% confirmed the diagnosis of vision-threatening DR and 89.2% had some level of DR.

Discussion: Teleretinal imaging programs not only increase patient compliance with diabetic retinal examinations but can also generate accurate referrals and yield high rates of compliance with follow-up.

Conclusions: These findings suggest that evaluating patients for DR in the primary care setting is an effective method of detecting vision-threatening retinopathy. However, assuring patient follow-up and treatment for vision-threatening DR detected in primary care telemedical networks remains a challenge.