Clinical Study Identifies Patients at Risk of Diabetic Eye Disease

Over 450,000 Oklahoma adults suffer from diabetes, according to the American Diabetes Association (ADA). Diabetes affects almost every part of the body, including the eye, and those with diabetes live with an increased risk for eye disease.

Diabetes is the leading cause of blindness among US adults. The disease increases the risk for diabetic retinopathy, cataracts, and glaucoma – all of which can lead to devastating vision loss.

Dr. Stephen R. Fransen at the Dean McGee Eye Institute is using the Oklahoma research community to help identify and diagnose patients who are at risk for diabetes-related eye disease.

Symptoms Go Unnoticed

The early symptoms of these diseases are often unnoticeable without a proper screening. That’s why eye screenings and early diagnosis are essential to diabetic care.

“Many patients don’t know they have a problem until long after they should have been treated,” Dr. Fransen says. “We can keep them from going blind if we can get to them in time.”

Dr. Fransen wants to find ways for more patients with diabetes to be screened and referred to the right eye specialist for care.

PROTECT2: A Clinical Study to Identify and Help Patients

PROTECT2 is a clinical trial studying the relationship between accessibility and the number of patients with diabetes who receive eye exams.

“A major part of the problem is that less than half of the people with diabetes see an eye doctor every year. With proper screening and treatment, we can prevent blindness in nine out of ten people. The purpose of the study is to see if a new way to do the screening will help get an eye exam for the people who are at increased risk for blindness,” Dr. Fransen says.

By making vision screenings available during primary care visits, he hopes to see an increase in the number of patients receiving necessary eye care.

“At-risk patients need two eye exams a year, but many don’t always adhere to that standard. It’s either they don’t feel it’s important or they don’t have time or transportation available to them,” says Dr. Madona Azar, Director of Adult Clinical Programs at Harold Hamm Diabetes Center and the principal investigator for PROTECT2.

During the study, Dr. Azar and her team saw patients with diabetes during regular check-ups. At the end of each checkup, patients could opt in for an onsite eye screening. The simple exam is done using a hand held medical device and identifies the patients who are at increased risk for blindness. The device sends data about the patient’s eye to an offsite retinal specialist who interprets the data and makes recommendations.

Patients at low risk are sent a letter with their results and reminded to come back in a year for another exam. Those that are at increased risk work with a team of nurses and social workers to make sure they follow-up with an eye doctor for a full exam.

A Holistic Care Approach

Diabetes is a disease that affects more than one area of the body. Many patients have related symptoms that require a range of expertise.

“Diabetes requires all over treatment. You need a lot of different specialists. Patients don’t always have the time to see each specialist,” Dr. Azar says.

A holistic approach at each appointment means that patients with diabetes can more easily access the different kinds of care they need from specialists more efficiently. When physicians like Dr. Azar can do basic screenings during initial patient check-ups, they can fast-track referrals to specialists when needed. This saves time and provides essential care to those who need it most.

Results of the trial look promising. Dr. Azar and her team captured 95 percent of patients and referred nearly one-third of those patients to eye specialists. Dr. Azar says patients benefit from the exam.

“They can have reassurance or the eye care they need before it’s too late.”

Dr. Fransen hopes eye exams during primary checkups will help protect the vision of patients and become a standard of care for diabetes treatment. Other state medical centers including the Chickasaw Nation Medical Center and the OU Physicians Family Medicine Center are also involved in the study.

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