Potential Efficiency Benefits of Nonmydriatic Ultrawide Field Retinal Imaging in an Ocular Telehealth Diabetic Retinopathy Program

Objective: To compare efficiency of nonmydriatic ultrawide field retinal imaging(UWFI) and nonmydriatic fundus photography(NMFP) in a diabetic retinopathy(DR) ocular telehealth program Research Design and Methods: Retrospective, comparative cohort study of patients imaged from 11/01/2011-11/01/2012. Images were evaluated for DR and diabetic macular edema(DME) using standard protocol at a centralized reading center with certified graders. Identification of DR, image evaluation time and rate of ungradable eyes were compared. Results: 1,633 and 2,170 consecutive patients were imaged using NMFP and UWFI, respectively. There were no statistically significant differences between groups in age, diabetes duration, gender, ethnicity or insulin use. The ungradable rate per patient for DR(2.9% vs 9.9%,p Conclusions: In a standardized DR ocular telehealth program, nonmydriatic UWFI reduced the ungradable rate by 71% (to less than 3%) and reduced image evaluation time by 28%. DR was identified 17% more frequently after UWFI was implemented and DR peripheral lesions may have suggested a more severe DR level in 9%. These data suggest that UWF imaging may improve efficiency of ocular telehealth programs evaluating DR and DME.