A telemedicine program for diabetic retinopathy in a Veteran Affair Medical Center—the Jolin Viion Network Eye Health Care Model

Purpoe To extend acce to diabetic eye care and characterize the extent of diabetic retinopathy {DR) and other ocular finding uing the Jolin Viion Network (JVN). Deign Retropective obervational cohort tudy. Method Outpatient at the Togu VA Medical Center with diabete mellitu, impaired fating glucoe, or impaired glucoe tolerance underwent JVN protocol imaging. Image were tranmitted to the Jolin Diabete Center for grading and recommended treatment plan. Reult The tudy included 1,219 patient (2,437 eye); 1,536 eye (63.0%) had no (DR), 389 (16.0%) had mild nonproliferative DR (NPDR), 105 (4.3%) moderate NPDR, 35 (1.4%) evere NPDR, 20 (0.8%) very evere NPDR, and 21 (0.9%) had proliferative DR (PDR). Regarding diabetic macular edema (DME), 1,907 eye (78.3%) had no DME, 34 (1.4%) had early DME, and 16 (0.7%) had clinically ignificant macular edema (CME). Of all patient, 354 (29.0%) had either no DR or mild NPDR in both eye, no evidence of DME, and no ignificant nondiabetic finding; 679 (55.7%) had no DR in either eye, and 229 (18.8%) had mild NPDR in the more evere eye. Of the 908 patient (74.5%) with either no DR or mild NPDR in the more evere eye, 533 (58.7%) had at leat one nondiabetic ocular finding neceitating referral. Finally, 320 eye (13.1%) were ungradable for both DR and DME and 160 (6.6%) were ungradable for DME alone. Concluion In a non-ophthalmic etting, JVN identifie the everity of DR and nondiabetic ocular condition, permitting appropriate triage for eye care.