Abstract
Purpose: :
To estimate the prevalence of diabetic retinopathy, using three-field digital photography in patients with diabetes mellitus in a general hospital where ophthalmologist is not available.
Methods: :
Patients from Endocrinology department of Saint Philibert hospital were screened consecutively from March 2007 to September 2008. Demographic and clinical data including date of birth, gender, type of diabetes, HbA1 c and albuminuria were recorded. Three 45° digital images per eye examinations were taken using a non-mydriatique fundus camera by a technician without dilatation and sent to the Department of Ophthalmology of Saint Vincent de Paul for grading by two ophthalmologists.
Results: :
A total of 1147 adults patients (52% males, 48% females) were included. Median age was 60 years (19-108). Most patients were type 2 diabetes (n= 1028, 90%). Mean HbA1c was 8%. Albuminuria was detected in 239 patients (20.8%). Of these 1147 patients, 521 (45%) said they never have had fundus examination previously. Retinal photograph of at least one eyes could not be graded in 172 patients (15%). Diabetic retinopathy was detected in 185 patients (19%). Suspected macular edema (hard exsudate within one disc diameter of the macular center) was found in 75 eyes (3,2%). Referral to an ophthalmologist was required in 356 patients (31%) for diabetic retinopathy and ungradable photographs.
Conclusions: :
Non-mydriatic photography, combined with telemedicine improve the screening of diabetic retinopathy and allow the identification of patients requiring further complete eye examination.
Keywords: diabetic retinopathy • clinical (human) or epidemiologic studies: prevalence/incidence