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Medicaid Patients with Diabetes from some Piedmont and Southeastern Counties Asked to Participate in Study to Prevent Blindness

WINSTON-SALEM, N.C. – About 3,000 North Carolina adults who have diabetes and are on Medicaid are invited to participate in a project called "I SEE IN NC” to determine if early screening using a special camera and images transmitted over the Internet can prevent blindness.

“Medicaid patients are rarely screened and are at risk of becoming blind,” said Ramon Velez, M.D., M.S., of Wake Forest University Baptist Medical Center, the principal investigator. Diabetes is the leading cause of preventable blindness in the United States and Velez said the study will determine if early referral to ophthalmologists will help.

Preliminary results from pilot testing of the high-tech approach showed that among diabetic patients screened, about 15 percent required urgent referral to an ophthalmologist and more than 40 percent had some degree of diabetic retinopathy – changes in blood vessels in the retina, Velez said. The test was conducted at Downtown Health Plaza of Baptist Hospital, part of Wake Forest Baptist.

I SEE IN NC is seeking Medicaid or uninsured patients who have diabetes in six Piedmont counties or six in the Wilmington area. The counties are Forsyth, Davie, Yadkin, Stokes, Surry, Wilkes, New Hanover, Brunswick, Bladen, Pender, Columbus and Onslow.

By comparing study counties with those not getting special screening, Velez and his colleagues will determine to what extent the screening reduces blindness.

Diabetic retinopathy can be treated by ophthalmologists, usually with a laser.

“Cases of blindness are partially attributable to the low levels of screening,” said Velez. “Screening identifies changes in the eye that the patient may not recognize. If treated early, blindness can be prevented.”

But, he said, the rate of screening among N.C. Medicaid patients is only about 14 percent.

Digital photography is the key to the plan. Trained personnel will take retinal photographs using a special digital camera. The digital images will be transmitted over the Internet and read at a diabetic retinopathy screening center in the Department of Ophthalmology at Wake Forest University School of Medicine, Velez said.

I SEE IN NC (Increasing Screening Eye Examinations for diabetic retinopathy IN North Carolina) is being supported by a $465,034 grant from the Duke Endowment to establish the reading center, and a $456,203 grant from the Kate B. Reynolds Charitable Trust to pay for the screening in the two networks. The N.C. Rural Health Foundation will pay for evaluation.

Velez said Medicaid data would be used to follow the patient outcomes in both the screening group and in the controls.

“Primary care physicians rarely perform dilated eye examinations,” said Velez, a professor of internal medicine at the School of Medicine. “A recent review of diabetic patients at the Downtown Health Plaza showed that fewer than 20 percent reported having been to an ophthalmologist in the previous three years.”

He said that in the pilot testing stage, the team used a Canon retinal camera, acquired through a grant from the North Carolina Lions Foundation. William P. Moran, M.D., formerly head of the Section on General Internal Medicine, is co-investigator.

If you have diabetes and are on Medicaid, or are uninsured, and live within Central Piedmont Access II – the six Piedmont counties --contact Ron Gaskins, M.P.A., associate project manager, at 336-480-6934 or rgaskins@wfubmc.edu. If you live within one of the Lower Cape Fear counties, contact Teale Jordan, R.N., project coordinator, at 910-763-0200 or teale.jordan@alcfnc.org.

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Media Contacts: Robert Conn, rconn@wfubmc.edu, or Karen Richardson, krchrdsn@wfubmc.edu, at (336) 716-4587.

About Wake Forest University Baptist Medical Center: Wake Forest Baptist is an academic health system comprised of North Carolina Baptist Hospital and Wake Forest University Health Sciences, which operates the university’s School of Medicine. The system comprises 1,187 acute care, psychiatric, rehabilitation and long-term care beds and is consistently ranked as one of “America’s Best Hospitals” by U.S. News & World Report.

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