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Introduction:We aimed to determine the prevalence and risk factors for diabetic retinopathy (DR) in a multi-primary healthcare facilities-based DR screening project by analyzing single-field fundus photographs among patients with diabetes in Rafsanjan City, Iran, based on the Rafsanjan Cohort Study, as a part of the prospective epidemiological research studies in IrAN (PERSIAN). Methods: Of all participants in the Rafsanjan Cohort Study (performed in four primary healthcare facilities across Rafsanjan City from August 2015 to December 2017), patients with diabetes were recruited in this study. All participants underwent a standardized interview and clinical and paraclinical examinations for demographic characteristics, and medical conditions according to the PERSIAN's protocols. In addition, digital fovea-centered and single-field fundus photography was performed for DR identification and grading. For assessment of agreement, a subgroup of participants underwent fundus examination, randomly. DR was graded as nonproliferative (NPDR) or proliferative (PDR). Results: Of 8414 screened participants, 1889 had diabetes. The total prevalence of DR was 6.93% [131 individuals including 110 (5.82%) with NPDR, and 21 (1.11%) with PDR] based on single-field fundus photographs, with almost perfect agreement with fundus examinations (j = 0.82). On adjusted multivariate analysis, duration of diabetes (OR 1.16, 95% CI 1.13-1.19), positive family history for diabetes (OR 1.73, 95% CI 1.09-2.75), fasting plasma glucose (FPG) C 126 mg/dL (OR 1.98, 95% CI 1.16-3.39), and serum creatinine level (OR 1.79, 95% CI 1.08-2.98) were associated with DR. Factors including age, education level, physical activity, body mass index, hypertension, and cardiovascular and renal diseases did not have association with DR on adjusted multivariate analysis. Conclusions: Single-field fundus photography can be used for screening of DR in primary healthcare facilities. In individuals with diabetes, duration of diabetes, positive family history for diabetes, FPG C 126 mg/dL, and serum creatinine level may be associated with DR.

A B S T R A C T BACKGROUNDDiabetes, having an impact on the immune system, will cause changes in the microbial flora of different organs. The aim of this study was to compare the ocular microbial flora of diabetic and non-diabetic patients as candidates for cataract surgery. METHODSIn this cross-sectional study, 380 diabetic and non-diabetic patients undergoing cataract surgery were selected by convenience sampling method. After informed consent, fasting blood sugar (FBS) and HbA1c were measured. Then, microbial culture of the conjunctiva was performed before surgery. Data were analyzed by independent T-test and fisher's exact test. RESULTSFrequency of Staphylococcus coagulase-positive in diabetic/non-diabetic patients was 0/6. The difference was significant (p=0.030). In addition, the frequency of funguses in diabetic/non-diabetic patients was 17/1 (p<0.001). Klebsiella, Staphylococcus coagulase-negative and Staphylococcus epidermidis in diabetic patients were higher than non-diabetics (p>0.05). CONCLUSIONSThe results of this study showed that, the rate of Klebsiella, Staphylococcus coagulase-negative, Staphylococcus epidermidis and Fungal species in conjunctival of diabetic patients was higher than non-diabetic. Therefore, ophthalmologists need to consider the immunology points in diabetic patients undergoing cataract surgery.