Smartphone-based Diabetic Retinopathy Screening
Author(s): Michelle Greiver, Simone Dahrouge, Jeremy Chad, Kevin Lai, Chris Damaso, Karen Rothschild, Roland Grad
Introduction: Retinopathy screening for people living with diabetes can prevent blindness. However, nearly 40% of persons living with diabetes in Ontario have not been screened within the recommended interval even though screening by optometrists or ophthalmologists is covered by OHIP.
Due to improvements in technology, diabetic retinopathy screening within family physicians’ offices, using a smartphone, may now be feasible.
Objectives: We will test the feasibility of a low-cost smartphone-based retinopathy screening process in one family practice. We will use the Welch Allyn PanOptic Plus iExaminer system. An earlier version has been successfully tested for retinopathy screening in a low resource setting. The system does not require dilatation of the pupil for good images.
Methods: The iExaminer System will be coupled with a smartphone app capable of exporting and attaching images directly to the patient’s EMR chart. The retinal images will then be securely submitted via eConsult to the ophtalmology provincial group for interpretation.
Sequential patients seen at the practice, living with diabetes and with no retinopathy screening for at least a year, will be asked to consent to smartphone retinal photography.
Outcomes: We will assess: the proportion of patients agreeing to photography; the feasibility of taking a retinal photograph and importing it to the EMR; the proportion of retinal photos that are clinically adequate for interpretation; the time taken for the process; acceptability for the practice nurses and for a 10% sample of patients.
Feasibility: Several stakeholders have already expressed interest in this project.