Mapping Evidence on the Management of Diabetic Retinopathy Using Teleophthalmology to Complement Human Resources for Eye Health: A Scoping Review Protocol

INTRODUCTION: Diabetic Retinopathy is the leading cause of blindness in working adults, and remains a serious public health concern, globally. Whilst extensive research has been done in this area, the prevention of diabetic retinopathy is still very poor. Attributing factors in previous studies have included shortage of Human Resources for Eye Health in primary health centres, and a shortage of technology and skill in most countries. In some countries, teleophthalmology has been introduced to assist in the management of diabetic retinopathy by capacitating Eye Health professionals in primary health care settings since diabetes is diagnosed at this level. Where implemented, management of diabetic retinopathy through teleophthalmology has further contributed to reduction in preventable blindness while minimizing turnaround times as patients no longer have to wait for an Ophthalmologist appointment. The main objective of this scoping review is to map evidence on the use of teleophthalmology in the management of diabetic retinopathy globally.

METHODS & ANALYSIS: Methodology will be guided by Arksey and O’Malley scoping review framework. We will search for literature from the following EBSCO Host databases: MEDLINE, Health source: Nursing/Academic Edition, Health source – Consumer, CINAHL and Academic Search Complete. PubMed, Google Scholar and Science Direct will also be searched for studies. Where articles are not accessible online, the author will be contacted for the article, failing which the University of KwaZulu-Natal library services will be asked for assistance. The literature search will be done for the period from January 2014 to October 2019 where all studies in English will be accepted. After the initial search, title, abstract and full text screening will be conducted by two independent reviewers. To assess the methodological rigour of included studies, the Mixed Method Appraisal tool (MMAT) 2018 will be used. Study results will be presented using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) chart.