Screening for diabetic retinopathy and reduced vision among Indigenous Australians in Top End primary care health services: a TEAMSnet sub‐study

Abstract

Background Diabetic retinopathy (DR) prevalence is higher in Indigenous Australians than in other Australians and is a major cause of vision loss. Consequently, timely screening and treatment is paramount, and annual eye screening is recommended for Indigenous Australians. Aims To assess the prevalence of DR, reduced vision and DR treatment coverage among Indigenous Australian adults with diabetes attending Top End indigenous primary care health services. Methods A cross‐sectional DR screening study conducted from November 2013 to December 2015 in two very remote Northern Territory Aboriginal primary healthcare services. Results In 287 subjects, the prevalence of non‐proliferative DR, proliferative DR and clinically significant diabetic macular oedema was 37.3%, 5.4% and 9.0% respectively. Treatment coverage for PDR was 60% (of 10 patients) and for CSMO was 17% (of 23 patients). Vision data were available from 122 participants at one site. The proportion with normal vision, reduced vision, impaired vision and blindness was 31.1%, 52.5%, 15.6% and 0.8% respectively. Overall, ungradable monocular image sets (46%) were associated with poorer quality images and missing protocol images (both P < 0.001). Ungradable images for DR were associated with presence of small pupils/media opacities (P < 0.001). Ungradable images for diabetic macular oedema were associated with poorer image quality (P < 0.001), cataracts (P < 0.001) and small pupils (P = 0.04). Conclusions A high prevalence of DR, CSMO and impaired vision was noted in Indigenous Australians with diabetes. Screening in primary care is feasible, but more effective screening methods are needed.

Considerations for Training and Workforce Development to Enhance Rural and Remote Ophthalmology Practise in Australia: A Scoping Review

“…The review identified 42 articles that reported on the incidence and prevalence of various eye diseases amongst the Indigenous population, including keratitis, visual impairment, vision loss, cataract, glaucoma, choroidal nevi, eye trauma, trachoma and diabetic retinopathy [ 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 ] ( Table 2 ). Irrespective of the study design, these studies collectively demonstrated that the prevalence of vision impairment and eye diseases in Aboriginal and Torres Strait Islanders (respectfully referred to as Indigenous Australians) is consistently higher compared to non-Indigenous Australians.…”

Prevalence of Diabetic Retinopathy in Indigenous and Non-Indigenous Australians

“…Of these, 15 studies enrolling 8219 diabetic participants were included in our systematic review and metaanalysis. 7,8,[24][25][26][27][28][29][30][31][32][33][34][35][36]…”