Retinal interventions rare among patients deemed low-risk on screening

This retrospective cohort study assessed the rate of retinal interventions among patients with minimal or no diabetic retinopathy on initial telemedicine screening.

Study design

Investigators identified patients with minimal (n=9,811) or no (n=69,634) retinopathy during an initial screening session that included two 45° fundus photos of the optic nerve and macula. Medical records were used to find patients who subsequently underwent retinal interventions—intravitreal injections, retinal lasers or pars plana vitrectomy—within 2 years of the baseline evaluation.

Outcomes

Of the patients who lacked baseline retinopathy, 11 required treatment for complications of diabetic retinopathy during the 2-year follow-up period (0.000079 patients per year). Eleven patients with minimal retinopathy also required intervention during the same time (0.000561 patients per year).

Limitations

Using the Current Procedural Terminology codes to identify interventions may have introduced inaccuracies and incorrect treatments. Approximately 15% of patients did not have a 2-year follow-up, which may represent a high-risk group with poor compliance.

Clinical significance

It is rare for patients with minimal or no baseline diabetic retinopathy, as seen on telemedicine screening, to require retinal interventions for diabetic eye complications in the subsequent 2 years.