Arquivos Brasileiros de Oftalmologia

In total, 437 patients with diabetes mellitus were included in the study (mean age: 62.5 ± 11.0 years; 61.7% female; mean diabetes duration: 15.3 ± 9.7 years; 67.8% insulin users). In the in-person assessment group, the average waiting time between primary care referral and specialist evaluation was 292.3 ± 213.9 days, with a referral rate of 73.29%. In the telemedicine group, the average waiting time was 158.8 ± 192.4 days, and the referral rate was 29.38%. The telemedicine approach significantly reduced the waiting time (p < 0.001) and significantly lowered the referral rate (p < 0.001).

This retrospective study evaluated a telemedicine-based diabetic retinopathy screening implemented during the COVID-19 pandemic and compared it with in-person strategies. The evaluation was conducted from the perspective of a specialized referral center in an urban area of Central-West Brazil. In the telemedicine approach, a trained technician captured retinal images using a handheld camera, and these images were sent to specialists for remote evaluation. Patient variables—including age, gender, duration of diabetes diagnosis, diabetes treatment, comorbidities, and waiting time—were analyzed and compared.

In total, 437 patients with diabetes mellitus were included in the study (mean age: 62.5 ± 11.0 years; female: 61.7%; mean diabetes duration: 15.3 ± 9.7 years; insulin users: 67.8%). In the in-person assessment group, the average waiting time between primary care referral and specialist evaluation was 292.3 ± 213.9 days, and the referral rate was 73.29%. In the telemedicine group, the average waiting time was 158.8 ± 192.4 days, and the referral rate was 29.38%. The telemedicine approach significantly reduced the waiting time (p < 0.001) and significantly lowered the referral rate (p < 0.001).

Our study highlights the successful implementation of a low-cost retinal camera and a telemedicine screening program for DR in a real-world public referral center. This strategy leverages the expertise of healthcare professionals in capturing retinal images and remote ophthalmologists in conducting the screening process, thereby effectively addressing the COVID-19 pandemicpresented challenges. The strategy provided a solution for continuity of care during these unprecedented times as well as facilitated an optimized workflow that likely enhanced patient access to healthcare services. Our study findings suggest that telemedicine screening programs involving portable retinal cameras and remote ophthalmologists have the potential to address the burden of DR, particularly in resource-limited settings.