Prevalence of ocular fundus pathology with type 2 diabetes in a Chinese urban community as assessed by telescreening

Liu, Lei; Geng, Jin; Wu, Jingyang; Yuan, Zhe; Lian, Jie; Hu, Desheng; Chen, Lei

doi:10.1136/bmjopen-2013-004146

Cited by 12 publications

(19 citation statements)

References 14 publications

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“…In particular, a study by Liu et al in China trained GPs to take photographs, which were read by a reading centre. Recommendations were returned to the GP for communication to patients . In South Africa, a mobile screening program integrated into different existing diabetes clinics.…”

Section: Resultsmentioning

confidence: 99%

“…Upper‐middle‐income countries had the most studies using fundus cameras, as well as an increased focus on identifying of DR risk and cases through primary care referrals. One study in China examined the possibility of structuring fundus camera examinations by general practitioners, while an initiative in South Africa reported a systematic national screening program; recommendations from both South Africa and Latin America, however, suggested that such programs may not be feasible in the near future.…”

Section: Resultsmentioning

confidence: 99%

“…Recommendations were returned to the GP for communication to patients. 38 In South Africa, a mobile screening program integrated into different existing diabetes clinics. The program found it difficult to incorporate screening into both the space and timing of clinic consultations.…”

Section: Screening Infrastructurementioning

confidence: 99%

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Addressing risk factors, screening, and preventative treatment for diabetic retinopathy in developing countries: a review

Lin

Ramulu

Lamoureux

et al. 2016

Clinical Exper Ophthalmology

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The number of people with diabetic retinopathy (DR) has increased with the increasing prevalence of diabetes mellitus worldwide, especially in developing countries. In recent years, the successful implementation of public health programs in developed countries has been thought to contribute to decreases in blindness from DR. Developing countries, however, have not seen the same improvements, and their public health interventions still face significant challenges. In this review we describe the current state of public health approaches including risk factor control, screening and treatment techniques for DR in developing countries, and suggest recommendations. While the awareness of DR is variable, specific knowledge about DR is low, such that many patients have already experienced vision loss by the time they are screened. Attempts to improve rates of screening, in particular through non-mydriatic cameras and tele-screening, are ongoing and promising, although challenges include collaboration with healthcare systems and technology failures. Laser treatment is the most readily available, with anti-VEGF therapy and vitreo-retinal surgery increasingly sought after and provided. Recommendations include the use of 'targeted mydriasis' for fundus imaging to address high rates of ungradable images, increased communication with diabetes management services to improve patient retention and mobilization of access to DR treatments.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Addressing risk factors, screening, and preventative treatment for diabetic retinopathy in developing countries: a review

Lin

Ramulu

Lamoureux

et al. 2016

Clinical Exper Ophthalmology

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show abstract

“…The same study also reported the sight-threatening consequence of DR to be higher in the rural areas (14.2%) compared with the urban areas (6.3%). Liu et al 9 reported the prevalence of DR to be 14% in patients living in the Fengyutan Community of Shenyang city in north-east China.…”

Section: Introductionmentioning

confidence: 99%

The profile of sight-threatening diabetic retinopathy in patients attending a specialist eye clinic in Hangzhou, China

et al. 2019

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Background/aimsTo examine the profile of diabetic retinopathy, awareness and self-help in patients attending a specialist eye clinic in Hangzhou, China.MethodsA total of 199 consecutive patients with diabetes (mean age = 57 years, SD = 11) attending eye clinic at the School of Medicine, Zhejiang University, Hangzhou were examined in a cross-sectional study. Clinical/demographic data were obtained from patients’ records. Fundus photographs obtained from each patient were graded using Early Treatment of Diabetic Retinopathy Study (ETDRS) criteria; severe non-proliferative, proliferative retinopathy and/or macular oedema (hard exudates/thickening around fovea) were classified as sight-threatening diabetic retinopathy (STDR). Optical coherence tomography was used to confirm the diagnosis of macular oedema. Data on knowledge/awareness about diabetes and self-help/lifestyle were collected using a structured questionnaire.ResultsSTDR was found in 80% patients of whom 18% had visual acuity of ≤counting fingers in at least one eye. Male gender, longer diabetic duration and use of insulin were significantly associated with STDR (p ≤ 0.05). Of the total, 41% patients reported that they were attending for the first time. Of all the first-time attendees, 67% had STDR. Also of all the first-time attendees, 14% were unclear whether diabetes affected their eyes. Fifty-one per cent of patients who thought their diabetes was well controlled had fasting blood sugar ≥6.5 mmol/L (p < 0.001). Of the total, 65% patients reported not doing ≥4 hours/week of physical exercise.ConclusionsThe majority of patients with diabetes presented to this eye clinic suffered with late-stage retinopathy. Our results advocate the need to improve diabetic diagnosis, management and awareness and to set up eye screening for diabetics in Hangzhou, China.

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“…15 CSME may cause permanent central blindness and occurs when leakage in the central retina disrupts photoreceptors. Timely treatment of CSME also dramatically reduces vision loss by up to 60%, 16,17 with greater efficacy using intravitreal injections of corticosteroids and anti-vascular endothelial growth factor medications. 18 The proportion of vision impairment caused by CSME versus proliferative DR has been reported to be approximately 2 to 1, but may vary depending on the population being screened.…”

Section: Rationale and Description Of Tmdrs Screeningmentioning

confidence: 99%

Telemedicine-based diabetic retinopathy screening programs: an evaluation of utility and cost-effectiveness

Cuadros

2015

SHTT

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Diabetes is the main cause of blindness among working age adults, although treatment is highly effective in preventing vision loss. Eye examinations are recommended on a yearly basis for most patients for timely detection of retinal disease. Telemedicine-based diabetic retinopathy screening (TMDRS) programs have been developed to identify patients with sightthreatening diabetic eye disease because patients are often noncompliant with recommended live eye examinations. This article reviews the cost-effectiveness of the various forms of TMDRS. A review of relevant articles, mostly published since 2008, shows that societal benefits generally outweigh the costs of TMDRS. However, advances in technology to improve efficacy, lower costs, and broaden screening to other sight-threatening conditions, such as glaucoma and refractive error, are necessary to improve the sustainability of TMDRS within health care organizations. Patient satisfaction with these telemedicine programs is generally high. New models of shared care with primary care providers and staff are emerging to improve patient engagement and follow-up care when individuals are found to have sight-threatening eye disease. TMDRS programs are growing and provide valuable clinical benefit. The cost-utility is currently well proven in locations with limited access to regular eye care services, such as rural areas, poor communities, and prison systems; however, improvements over time are necessary for these programs to be cost-effective in mainstream medical settings in the future.

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Prevalence of ocular fundus pathology with type 2 diabetes in a Chinese urban community as assessed by telescreening

Cited by 12 publications

References 14 publications

Addressing risk factors, screening, and preventative treatment for diabetic retinopathy in developing countries: a review

Addressing risk factors, screening, and preventative treatment for diabetic retinopathy in developing countries: a review

The profile of sight-threatening diabetic retinopathy in patients attending a specialist eye clinic in Hangzhou, China

Telemedicine-based diabetic retinopathy screening programs: an evaluation of utility and cost-effectiveness

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