492-P: Implementation of Retinal Scans in a Pediatric Diabetes Clinic to Improve Screening in a Non-commercially Insured Population

Background: The SEARCH for Diabetes in Youth Registry reported the prevalence of diabetic retinopathy in children with Type 1 and Type 2 diabetes as 5.6% and 9.1% respectively. The American Diabetes Association recommends annual retinopathy screening in children ≥ 11 years of age or at onset of puberty whichever is earlier, 3-5 years after diagnosis of Type 1 diabetes. The screening is recommended annually immediately after diagnosis of Type 2 diabetes. In our academic endocrinology practice, we have 2000 established patients with Type 1 diabetes and 900 patients with Type 2 diabetes. Our non-commercially insured population is around 40%. Methods: NIDEK Navis- EX retinal scanner was installed in June 2020 in the clinic for the Medicaid population to improve screening since this group had suboptimal retinal screening. The scan was performed by the medical assistants at check-in during the diabetes clinic visit based on eligibility. The images were transferred to the ophthalmology colleagues for a reading. Once the read was completed, the results were sent back to the patient’s electronic medical records. Results: The retinal scan screening was at 37.4% for all insurance groups prior to the implementation of the scanner. After the installation of the scanner, the screening rates increased to 48.7%, 64.8%, and 64.8% at the end of years 1, 2, and 3 respectively in the non-commercially insured group. Among the 349 patients screened in our clinic during the 1st year, 7 had non-proliferative diabetic retinopathy. Conclusions: We improved the retinopathy screening rates in the non-commercially insured population at our center. We are working with our institution, so we can perform retinal scans in our clinic for all our patients without a huge financial burden for our families. Disclosure I. Thakur: None. A. Choudhary: None.