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L Chui, P Dunbar, V KozousekNova Scotia Diabetic Retinopathy Screening Group; Outcome Analysis of a Pilot Community Population-Based Screening Program for Diabetic Retinopathy . Invest. Ophthalmol. Vis. Sci. 2002;43(13):4386.
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Purpose: The purpose of this pilot was to improve the screening rates of diabetic retinopathy in selected Nova Scotian communities and to determine the number of individuals with unrecognized and/or untreated sight threatening retinopathy. Methods: Three First Nations and three non-First Nations communities were selected for screening. The program adopted a community-based screening approach and used a mobile camera, ophthalmic photographer, local area nurses and trained volunteers. Referrals from health care professionals as well as self-referrals from persons with diabetes, were accepted for the program. The screening examination consisted of patient consent and confidentiality explanation, standard visual acuity determination, blood pressure measurement, and fundus photography of 3 fields (in both eyes) using a standard, mydriatic 30º fundus camera. Independent evaluation of the processed slides was performed by 2 graders. Results: 449 people were screened. 55% (249) had never had a dilated eye exam in the past. 16% (73) were found to need further assessment by ophthalmology. 63% (46) of this group were new referrals to ophthalmology; the remaining 37% (27) had been seen at least once before by an ophthalmologist or optometrist. Of the 73 individuals needing further assessment, 44% (32) were referred due to their level of retinopathy (level 47 or worse by the modified ETDRS classification), 30% (22) were referred due to inadequate photographs, 10% (7) were referred for findings suspicious of glaucoma and 16% (12) were referred for other findings. Blood pressure measurements were found to be within the recommended diabetic limits in 30% of First Nations' individuals and 50% of non-First Nations' individuals. Conclusion: Preliminary results show this pilot project is meeting its goals of improvement of retinopathy screening rates and detection of vision threatening pathology.
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