Prevalence of hypertensive retinopathy among the known diabetics in a community-based setting using a non-mydriatic fundus camera

Abstract

Hypertension is a leading cause of morbidity and mortality and is associated with the risk of cardiovascular, cerebrovascular disease, and target organ damage. The risk increases exponentially in individuals with diabetes. Hypertensive retinopathy is a marker for target organ damage, so screening for hypertensive retinopathy helps in cardiovascular risk stratification. This study was conducted with an objective to screen for hypertensive retinopathy among known diabetics using a portable non-mydriatic fundus camera to ascertain its prevalence. The study was conducted in three selected field practice areas of the Department of Community Medicine. A house-to-house survey was performed using a predesigned, pretested questionnaire among 302 known diabetics. The study participants were subjected to visual acuity examination using Snellen's chart and retinal fundus examination using a portable non-mydriatic Bosch Mobile Eye Care Solutions fundus camera. The fundus images were transferred to a laptop and were reviewed and graded by an experienced Ophthalmologist. Among the 302 participants studied, 60 were diagnosed with hypertensive retinopathy. The prevalence of hypertensive retinopathy among diabetic patients was 19.9 % (95% CI: 15.7% - 24.6%). The prevalence was found to be higher in ** (21.8%; 95% CI: 16% - 28.6%) as compared to ** (17.5%; 95% CI: 11.8% - 24.6%). Early detection of hypertensive retinopathy with cardiovascular risk stratification and initiation of prompt treatment among the high-risk individuals will help reduce the morbidity caused due to end-organ damage and premature mortality to a greater extent and will pave the way forward to achieving sustainable developmental goals.