How It Works

Diabetic retinopathy is one of the most difficult complications of diabetes, especially because the disease doesn’t produce early symptoms. However, with early detection and treatment, most cases of vision loss and blindness can be prevented.

The Joslin Vision Network (JVN) is an innovative retinal imaging program designed to detect these vision problems early on. Using Joslin’s custom software and specialized cameras, patients are evaluated for diabetic eye disease. This evaluation usually happens at their primary care physician’s, or endocrinologist’s office.

JVN images, along with other patient data, including blood pressure and A1C values, are sent to the JVN Reading and Evaluation Center at Joslin Diabetes Center in Boston. There, the Joslin’s expert team of ophthalmologists, optometrists, and clinical staff evaluate and interpret the images. They identify specific levels of diabetic retinopathy — and then offer appropriate treatment guidance for each patient.

    While a patient is being seen in their primary care physician’s, or endocrinologist’s office, a JVN imaging specialist certified by Joslin Diabetes Center takes digital images of the patient’s retina using Joslin’s custom software and imaging hardware. The procedure is fast, pain free, and does not involve pupil dilation.

    In addition to the patient’s digital retinal images, important medical and care history is gathered to identify risk factors that influence eye disease onset, progression and care management. This information includes blood pressure and A1C values (the average blood glucose measurement during the two to three months before the date the A1C test was taken). Key education material may be presented during the imaging process to help patients understand how general diabetes management affects vision.

    The JVN images and medical and care information are sent to the JVN Reading and Evaluation Center at Joslin Diabetes Center in Boston where clinicians expert in diabetes eye care evaluate the inbformation. Evaluation and care summaries are returned to the ophthalmologist or primary care physician within two business days. The Joslin team also identifies ocular pathologies other than diabetic retinopathy if observed.

    With regular and careful follow-up combined with timely and appropriate laser surgery and medical treatment, the JVN can help reduce the risk for severe visual loss by over 95%.

    JVN is based on more than two decades of research, development, and testing. The accuracy of JVN as a diagnostic tool for diabetic retinopathy has been rigorously described and validated in several scientific peer review journals.

    These reports and other publications have provided rigorous evidence of JVN’s clinical effectiveness and its ability to:

    • Compare favorably with “Gold Standard” retinal imaging with dilated pupils (Ophthalmology 2001, Telemedicine and eHealth 2012, American Journal of Ophthalmology 2012)
    • Compare favorably with clinical exam through dilated pupils by retinal specialist (Retina 2003, Telemedicine and ehealth 2012, American Journal of Ophthalmology 2012)
    • Enhance an existing eye care professional referral program by increasing the rate of surveillance and treatment of diabetic retinopathy (Diabetes Care 2005, Ophthalmology 2016, Telemedicine and eHeath 2023)
    • Identify nondiabetic eye disease in a manner similar to clinical exam performed through dilated pupils by retinal specialist (Ophthalmology May 2006, JAMA Ophthalmology 2016)
    • Match favorably with regard to the sensitivity and specificity of dilated retinal exams for detecting diabetic retinopathy (Diabetes Care 2006, Diabetes Care 2014)
    • Efficiency benefits with the use of ultrawide field retinal imaging in diabetic retinopathy screening programs (Diabetes Care 2014)
    • Provide real-time retinal image evaluation at the point of care (Diabetes Care 2015)
    • Substantial reductions in retinal image ungradable rates and increased disease identification in a National Teleophthalmology Programs for diabetic retinopathy (Ophthalmology 2016)
    • Improved disease identification with integration of macular optical coherence tomography and ultrawide field retinal imaging in teleophthalmology program (Retina 2023)

    To make an appointment with the Beetham Eye Institute, call 617-309-2552 or make an appointment online.