Remote screening of retinal and optic disc diseases using handheld nonmydriatic cameras in programmed routine occupation
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RETINAL DISORDERS
Remote screening of retinal and optic disc diseases using handheld nonmydriatic cameras in programmed routine occupational health checkups onsite at work centers Miguel A. Zapata 1,2 & Ruth Martín 3 & Claudia Garcia-Arumí 4 & Alex Fonollosa 2 & Ignacio Flores-Moreno 2 & Roberto Gallego-Pinazo 2 & Estanislao Gutiérrez 2 & Maximino Abraldes 2 & Javier Zarranz-Ventura 4,5 & On behalf Optretina Reading Group Received: 22 April 2020 / Revised: 20 July 2020 / Accepted: 23 July 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Purpose To evaluate the first year outcomes of a remote screening program for detection of retinal diseases using handheld nonmydriatic cameras in occupational routine checkups performed onsite at work centers. Methods Cross-sectional, first year screening program outcomes audit. Participants were volunteers recruited from staff within work centers. Retinal fundus images were captured by technicians, and images and data were anonymized and sent securely to a remote server. A team of ophthalmologists, all retinal specialists, remotely read the images using a custom-made software and sent telematic reports of findings within 24–48 h. The main items evaluated were the detection of retinal abnormalities and the relationship between retinal findings and demographic data such as age and sex. Results A total of 19,881 workers were evaluated in 52 centers. Mean age was 41.1 years old, 43.9% men and 56.1% women. Mean duration of the test was around 2 min. Of the workers, 7.8% presented abnormalities in retinal fundus images, being the main findings choroidal nevus (2.4%), macular pigment abnormalities (1.5%), glaucomatous optic disc (1.2%), and macular signs of high myopia (1.1%). The presence of abnormalities was associated with greater age, being 5%, 7.9%, 12.6%, and 19.7% in workers less than 40 years, from 40 to 49, 50–59, and ≥ 60 years (p < 0.05), respectively. Men had more abnormalities in retinal fundus images than women (8.6 vs. 7.2; p < 0.05 RR: 1.2; CI 1092–1322). Conclusions Mass screening of retinal and optic disc abnormalities during occupational health routine checkups is a feasible, quick, and efficient tool for early detection of potential vision-threatening disease markers. Keywords Screening . Telemedicine . Retinal diseases . Optic nerve diseases . Occupational health
Introduction
* Miguel A. Zapata [email protected] 1
Optretina, C/ Las Palmas 11, 08195 Sant Cugat del Vallès, Barcelona, Spain
2
Optretina Image Reading Team, Barcelona, Spain
3
Hospital Vall Hebron, Barcelona, Spain
4
Hospital Clínic of Barcelona, Barcelona, Spain
5
Institut de Investigacions Biomediques August Pi Sunyer (IDIBAPS), Barcelona, Spain
Routine occupational health checkups for employees are commonly organized in a periodical basis by employers and companies in many countries. Regulations differ between countries, being mandatory or voluntary depending on the framework, except in certain sectors such as the chemical industry or other industries where t
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