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Dorottya Szabo, Gabor Laszlo Sandor, Gabor Toth, Iren Szalai, Regina Lukacs, Anita Pek, Georgina Toth, Andras Papp, Janos Nemeth; Conducting a Rapid Assessment of Avoidable Blindness (RAAB) survey with Diabetic Retinopathy (DR) module in Hungary. Invest. Ophthalmol. Vis. Sci. 2016;57(12):1571.
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© ARVO (1962-2015); The Authors (2016-present)
To estimate the prevalence and causes of avoidable blindness, severe visual impairment (SVI), moderate visual impairment (MVI), early visual impairment (EVI) and to determine the prevalence of diabetic retinopathy (DR) in Hungary.
A sample size of 3675 was calculated using the standard Rapid Assessment of Avoidable Blindness software. 105 clusters of 35 people 50 years of age or older were selected through probability proportionate to size sampling. Within clusters, households were selected using compact segment sampling. Visual acuity was measured with a Snellen tumbling E-chart with or without pinhole. After the examination by an ophthalmologist, all of the participants underwent a finger-prick random blood glucose (RBG) test using digital glucose meter, and were classified as having diabetes if they had previous diagnosis of this condition, if they received diabetic medication, or had RBG level of 200 mg/dl or more. All participants assessed with diabetes underwent dilated eye examination at the household in a darkened room with direct and indirect ophthalmoscope using a 20 D lens. The Scottish DR grading system was used for classification.
The standardized prevalence rates of bilateral blindness, SVI, MVI and EVI were 0.9% (95% CI:0.6-1.2), 0.5% (95% CI:0.2-0.7), 5.6% (95% CI:4.8-6.4) and 7.5% (95% CI:6.5-8.5), respectively. Age related macular degeneration (AMD), cataract, and other posterior segment diseases were the major causes of blindness in Hungary and cataract was the principal cause of SVI, MVI and EVI. Cataract surgical coverage (CSC) was 90.7%. Of all bilateral blindness in Hungary 48.5% was considered avoidable. Among the examined people aged 50 and over in Hungary, the prevalence of diabetes was 20%. Any sign of DR showed by 20.1% of patients with diabetes, and 7.9% showed any sign of maculopathy.
This survey was the first population-based study on blindness and visual impairment in Hungary, and demonstrated that AMD, cataract and other posterior segment diseases are the leading causes of SVI and blindness. The prevalence of diabetes was higher than expected.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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