Retina Risk App
November 10, 2019
San Diego County Optometric Society Newsletter: Retina Corner
By Nikolas J.S. London, MD FACS
President and Director of Clinical Research, Retina Consultants San Diego
Chief of Ophthalmology, Scripps Memorial Hospital La Jolla
Dear SDCOS membership,
Hard to believe fall is almost over and the holidays are upon us again. 2019 has been another wonderful year despite what sometimes feels like an endless cycle of political turmoil. I continue to be extremely impressed with all of my colleagues, and as Thanksgiving is approaching I wanted to thank all of you for your excellent care for our patients and for trusting us to care for yours. We have a wonderful eye community in San Diego.
Perhaps fitting for the season of overeating, this month I wanted to focus on diabetic retinopathy (DR), and in particular, an interesting new phone app that might help to empower our patients to understand more about the effect of diabetes on the eyes as well as how several modifiable risk factors perpetuate diabetic retinopathy.
As we know, DR is the leading cause of blindness in working-aged adults, with diabetic macular edema the leading cause of vision loss in patients with DR. This problem is endemic in some parts of the country and looks to only get worse. By 2030 many states will see 20% of their population diagnosed with diabetes, with nearly 30% of these patients affected by DR. Fortunately we have something to offer patients as antiVEGF injections can have a profound effect on slowing and even reversing DR. Overall, 40% of patients will have a significant regression in DR with antiVEGF treatment, and up to 80% of patients with severe non-proliferative DR will have a significant regression. This is wonderful, but even better would be empowering our patients to not have significant DR in the first place! The risk factors for DR are relatively simple, and include uncontrolled hypertension, duration of diabetes, and poor glycemic control. While patients can do nothing about the duration of their disease, they can about the other two, and a free new tool called Retina Risk App from Risk Medical Solutions may help. The app allows users to input their data to get an evidence-based calculation of their risk of developing sight-threatening retinopathy over the subsequent 5 years. Users can then modify those risk factors to see the effect on their calculations – bump the A1c from 6.0 to 13.0, and the risk will skyrocket. The app is very easy to use and the results are impactful.
The app was developed through a collaboration of ophthalmologists and endocrinologists out of Reykjavic, Iceland. It uses a proprietary algorithm that was clinically validated in a Northern European cohort of patients with diabetes – nearly 20,000 patients of different races and ethnicities – and published in peer-reviewed journals. The developers plan to validate in more populations as well incorporate other potential risk factors such as obesity, obstructive sleep apnea, smoking, and a history of other diabetes complications. In addition to calculating the risk of developing sight-threatening retinopathy, the app includes pages of educational information for patients to understand the pathophysiology of the disease.
We all see patients with diabetes, and I would encourage you all to download and check out this app for yourselves. Consider showing it to your patients, or using it as a springboard for discussing their risk of developing retinopathy. Information about the app can be found at www.retinarisk.com.
Thanks again for reading. Please don’t ever hesitate to contact me.
Best wishes, and until next time,