Welcoming teleretinography into diabetes integrated care.

Integrated Care (IC) is a perfect fit for people with diabetes. Fundus examination (FE) is a disease marker for diabetologists and identifies potentially blinding complications (Diabetic Retinopathy, DR). In our Diabetes Clinic (DC) in Pescara, Italy, FE is possibly provided with telemedicine in same day as other exams, avoiding it to be a standalone clinical one; images taken with a retinal digital camera are graded by a remote ophthalmologist within a shared Electronic Health Record (EHR), immediately readable by other stakeholders; a dedicated care path to the Eye Clinic, University of Chieti-Pescara is provided for urgent cases.

Why Miss the Chance? Incidental Findings while Telescreening for Diabetic Retinopathy.

Purpose: To report on incidental pathological findings met while screening for Diabetic Retinopathy (DR) in Diabetes Clinics (DC) by ophthalmologist-graded digital fundus imaging.

Methods: At the DC of Pescara (central Italy), for 3,859 eyes of 1,930 consecutive patients having not undergone fundus examination in the last year, two mydriatic fundus digital images, taken with a CenterVue DRS Digital Retinal Camera, were sent along with Best Corrected Visual Acuity, on a "store-and-forward" basis, to an ophthalmologist trained in DR screening, and graded according to the UK Diabetic Eye Screening Programme. Incidental fundus abnormalities other than DR were reported.

Vision-related quality of life and locus of control in type 1 diabetes: a multicenter observational study.

Aims: Diabetic retinopathy remains asymptomatic until its late stages but remains a leading cause of vision impairment and blindness. We studied quality of life and the ability to deal with the discomfort deriving from the presence of a chronic disease in patients with type 1 diabetes and different stages of retinopathy.

Methods: Multicenter collaborative observational study involving nine centers screening for retinopathy in different areas of Italy.

[Blindness and social security in Italy: critical issues and proposals.].

In Italy, blindness and low vision are ruled by Law 138/2001: two categories of blindness (corresponding to the one in the current WHO classification), receiving economical remuneration, and three categories of low vision, not directly remunerated. The problem ensues that low vision patients, who better gain from rehabilitation, have no economical contribution to undergo such care pathways; moreover, in Italy the evaluation has not yet shifted from "visual function" to "functional vision", thus lacking a holistic evaluation of visual dysfunction impact on the patient's daily life skills. To quantify the visual function of the examinee, only subjective performance (visual acuity and/or visual field) is evaluated in accordance with Law 138/2001, thus paving the way to malingerers: the "false blinds" phenomenon has recently reached the media.