Screening of Diabetic Retinopathy in a Diabetic Medical Center

Abstract

Purpose: To estimate the prevalence of diabetic retinopathy on the posterior
pole of newly diagnosed diabetic patients using a non-mydriatic fundus camera.
Materials and Methods: Descriptive case series of 822 patients (male: female
29.4:70.6), screened during 10 months (August 2014-May 2015) was done in
Diabetes Endocrine and Metabolic Centre (DEMC) using a single posterior pole
photograph centered on the fovea using a non-mydriatic fundus camera. Without
pupil dilation, grading of diabetic retinopathy was done using Airlie House
classification which divides diabetic retinopathy (DR) into 5 grades i.e.
background DR, pre-proliferative DR, proliferative DR, maculopathy and
advanced disease. After grading, patients were referred to eye outpatient
department for further management. Newly diagnosed diabetics, including
pregnant and hypertensive patients were studied. Patients with hazy media,
cataracts and evisceration were excluded.
Results: 170 (20.6%) out of 822 patients showed diabetic retinopathy in which
10 patients had type 1 (5.8%) while 160 patients (94.1%) had type 2 diabetes at
presentation. Highest distribution of diabetic retinopathy belonged to the age
group 50 (21.7%) (Mean 50.4, Std. Deviation 9.76). Out of 170, 98 patients
showed background diabetic retinopathy (57.6%), 31 patients showed preproliferative
(18.25%), 20 patients showed proliferative diabetic retinopathy
(PDR) (11.7%), 12 showed maculopathy (7.05%) and only 9 patients (5.2%)
showed advanced disease. Patients with vitreous hemorrhage, tractional retinal
detachment and neovascular glaucoma were considered as having advanced
disease. These results were totally based on posterior pole findings of diabetic
patients. Out of 170 patients, 8 had nephropathy (4.7%), 122 had neuropathy
(71.7%) and 99 patients (58.2%) had preexisting hypertension.
Conclusion: Fundus photograph with a non mydriatic camera in a diabetic
medical center is a very useful tool to guide patients for early treatment, to
prevent blindness.
Key words: Diabetes Mellitus, Fundus camera, Diabetic retinopathy screening.