Frequency of retinopathy in patients with diabetes screened by fundus photographs: a study from primary health care

Abstract

Objective: To determine the frequency, severity and risk indicators of diabetic retinopathy (DR) in patients with diabetes attending a primary care diabetes centre. Methods: This observational study was conducted at Diabetic Association of Pakistan - a World Health Organization collaborating center in Karachi, from March 2009 to December 2011. Registered patients with diabetes were screened by two field fundus photographs. Retina specialists graded the signs of retinopathy according to diabetic retinopathy disease severity scale. Results: Of total registered diabetic patients (n=11,158), 10,768 (96.5 %) were screened for DR. Overall DR was found in 2661 (24.7%) patients. DR was found in decreasing order of frequency in patients with type 2 (n= 2555, 23.7%) followed by patients with type 1 diabetes (n=101, 0.93% ) and patients with gestational diabetes mellitus (GDM) (n=5, 0.46%). Among patients with DR, signs of non-sight threatening retinopathy was dominant. Females and patients of working age group predominantly had retinopathy. Type 1 patients >16 years and type 2 patients < 5 years of history of diabetes had sign of retinopathy in increased frequency. Conclusion: Every forth patient with diabetes in this large cohort had signs of diabetic retinopathy. Females and patients in working age group predominantly had retinopathy. Type 2 patients with short while type 1 patients with long history of diabetes most frequently had DR. Dissemination of the present study findings may help in increasing the awareness of this serious complication of diabetes.

Results of a community-based screening programme for diabetic retinopathy and childhood blindness in district Hyderabad, Pakistan

“…There has been a variable prevalence of DR in national studies ranging from 15% to 58%, probably due to the different sample sizes and most of the studies being hospital based. 12–14 In our study, the prevalence of DR was 17% which is comparable to the data available. But our sample size was larger than most of the studies as we screened a large population which has not been done before.…”

“…Previous Fred Hollows Foundation (FHF) projects and other studies have demonstrated that DR is present in up to 30% of persons known to have diabetes. Therefore, it is estimated that in District Hyderabad, there are approximately 58 000 persons at risk of vision loss from DR. 12 …”

An Assessment of Knowledge, Attitude and Practices (Kap) Towards Diabetes and Diabetic Retinopathy in a Suburban Town of Karachi

“…Diabetic Retinopathy (DR) is a well-recognized complication of diabetes mellitus. Out of 39 million global blindness due to various eye diseases, 4.8% (1.8 million) is due to Diabetic Retinopathy (DR) 1 - 3 Nationally every fourth patient with diabetes has some level of DR 4 , 5 with improved care the diabetics are living longer and are exposed to the risk of chronic complications like DR resulting in increasing blindness. Health care providers are exploring ways and means to control blindness due to diabetes.…”

Retinal involvement in type 1 diabetics, an experience from a specialized diabetes care unit of Karachi, Pakistan.

“…21 Similarly, previous local study shown advance diabetic eye disease (TRD) to be 2% in type 1 diabetics. 22 This study reported 2.6% of CSME in h type 1 diabetics. Reports from other part of the world demonstrates that 97% type 1 diabetics developed retinopathy after 25 years of disease.…”