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Web-based screening may be useful in underserved areas

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FORT LAUDERDALE, Fla. — A Web-based screening approach may be used successfully to identify diabetic retinopathy remotely, according to one speaker here.

Michael D. Abràmoff, MD, PhD, and colleagues screened 1,676 patients in a primary care setting in the Netherlands to determine the impact of Web-based screening for ocular maladies. In the Netherlands, the ratio of ophthalmologists to patients is 1:40,000, he said here at the International Society for Imaging in the Eye meeting.

The EyeCheck Project screened patients between January and December 2003. The system the researchers used was secure and compliant with privacy standards applicable in the Netherlands and in the United States, Dr. Abràmoff said.

After completing a brief questionnaire, subjects underwent fundus imaging administered by nurses, he said. The subjects’ pupils were dilated at the discretion of the referrer, Dr. Abràmoff said. Results were graded either “suspect” or “not suspect” for diabetic retinopathy by remote observers.

“Type 1 patients had much higher rates of ‘suspect for diabetic retinopathy’ (34.5%) than type 2 patients (9.4%),” the study authors said in their presentation abstract.

Grader agreement was high (0.993) among the photographs reviewed, demonstrating the effectiveness of Web-based screening. However, because there was a higher incidence of photographs graded suspect for diabetic retinopathy, Dr. Abràmoff said Web-based screening might not be appropriate for patients with type 1 diabetes.