Ocular Health Screening in a Type 1 Diabetes Mellitus Population
DOI:
https://doi.org/10.17140/DROJ-4-138Keywords:
Type 1 diabetes mellitus, Ocular screening, elemedicine, Non-mydriatic retinal camera, T, OCT, OCTA, DICOM, Retinopathy.Abstract
Background: Type 1 Diabetes Mellitus is among the most common conditions worldwide, affecting nearly 95 million children
worldwide. One of the detrimental effects of this condition can be vision loss. Comprehensive annual ocular screenings can have
an important role in early detection and management of vision-threatening complications. Over 2,200 family members and children
with diabetes type 1 (www.childrenwithdiabetes.com) from Australia, Asia, Canada, Europe, Latin America and the United States
of America attended an annual meeting where participants wishing to undergo a full ocular wellness screening had to pre-register
for this weeklong activity. Methods: Sixteen (16) volunteer screeners made up of second year medical students, allied health care specialist, physician optometrist and ophthalmologist participated in this yearly event since 2007. Ocular wellness screening involved several stations where participants went through 8 stations, which included personal/family health history, visual acuity (Snellen visual chart), non-contact auto-tonometry for measurement of intra-ocular pressure, automated-refractor, and optical coherence tomography angiography (OCT and OCTA). The last station was a Canon non-mydriatic retinal camera used to acquire an anterior segment, as well as 45-degree fundus color and mono-chromatic auto fluorescence images (FAF). Results: Two hundred and sixteen (216) participants or 10% of the attendees (average age 21-years-old) underwent this screening event at the Disney Property in Orlando, Florida. Forty-one (41) participants had some retinal hemorrhages findings including microaneurysms, dot hemorrhages, flame hemorrhages and Intraretinal Microvascular Abnormalities (IrMa). Fifty-six (56) cases had varying levels of nuclear sclerosis. Three on-site readers evaluated all collected data and counseled families on findings. Participants with proliferative diabetic retinopathy findings or macular edema seen on OCT were referred to a remote off-site board-certified ophthalmologist through a secure line following Digital Imaging and Communications in Medicine (DICOM) and Health Insurance Portability and Accountability Act (HIPPA) protocols and recommended for further workup or treatment by the participant’s eye-care professional. Conclusions: Creating a safe and comprehensive yearly ocular screening for children with type 1 diabetes mellitus along with a positive learning experience for can improve the lives of those living with type 1 diabetes and their families. Early detection, prevention and management of vision threatening diseases (VTDs) insures the affected individual can safeguard their vision.
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