Introduction & Objective: Despite the rare occurrence of retinopathy in youth with diabetes (DM), routine screening is required. For type 1 diabetes (T1DM), screening starts at age 10 yrs. and DM duration of 5 yrs.; for type 2 diabetes (T2DM), at diagnosis.
Methods: Retinopathy screening with non-mydriatic fundus photography with Welch Allyn RetinaVue 700 Imager (RV) was offered to eligible DM patients at a pediatric, tertiary care center. Completed scans were reviewed by an ophthalmologist at the same center. Completion and reasons for incomplete testing were tracked. Control charts analyzed monthly completion. Refining implementation and uptake occurred through iterative PDSA cycles.
Results: From 10/20 to 12/23, 449 RV scans were completed (71% T1DM), and 4 (<1%) patients had retinopathy. There was a significant shift in completion in 1/23 from 49.9% to 73.5% among eligible patients, who attended a visit with a RV order. In 2023, the most common reason for incomplete testing among eligible patients was a scheduled ophthalmology appointment (32%). Observation showed RV added ~5 minutes to clinic time. Overall, biannual retinopathy screening between CY19 and CY23 increased from 33 to 37% among eligible T1DM patients and from 25 to 55% among T2DM patients.
Conclusion: Data suggest that non-mydriatic fundus photography with RV is a feasible method for increasing screening for retinopathy especially among pediatric patients with T2DM.
E. Rhodes: None. O.R. Sterns: None. R. Hirsch: None. S. Nanavati: None. E. Gonzalez: None. K. Garvey: Advisory Panel; Sanofi.
