SCREENING OF DIABETIC RETINOPATHY USING A NON-MYDRIATIC CAMERA

R. Arana, B. Amillategui - Fundacion para la Diabetes, Madrid, Spain.
C. Marcuello, A. Mateo - Hospital Clínico Universitario (Zaragoza), Zaragoza, Spain.
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Background and Aims: Diabetic retinopathy (DR) is the most common cause of blindness and visual impairment in the working age population of the developed countries. The current recommendation is to perform an annual dilated funduscopic examination by an ophtalmologist, and such an examination will be required more frequently if retinopathy is progressing. These explorations are expensive and time-consuming, so that many Ophtalmology Services are not able to cope with it. As a result, a high percentage of diabetic patients do not attend to their annual review.

As the non-mydriatic camera has demonstrated to be a reliable alternative for the screening of DR, we have tried to carry out the screening of diabetic patients who had not had an ophtalmological exam in the twelve previous months.

Materials and Methods: The Fundación para la Diabetes sent a letter to all the 230,000 homes of Saragossa (700,000 inhabitants), so as to inform people about the ocular risks of diabetes and to invite to diabetic patients, mainly those who had not attended to their routine ophtalmological exploration in the previous year, to a free of charge revision in the hospital, after a telephonic appointment.

Pharmacists at chemists´shops also collaborated by informing the people with diabetes about the risk of suffering retinopathy and the importance of early diagnosis to prevent blindness.
By means of the non mydriatic camera, an ophtalmologist and an endocrinologist performed the retinal photographs. The campaign lasted ten months.

Results: 943 diabetic patients attended to the hospital. 462 out of these patiens (48.99 %) had never had a funduscopic examination. 70 patients (15.15 %) were diagnosed of DR. As to the other 478 subjects (50.69 %), 219 (23.22%) had had their ophtalmologic exam in the last 12 months, whereas in the other 253 (26.83 %) had passed more time since the previous funduscopy. The total time to photograph both eyes of every patient never exceeded 10 minutes.

Conclusion: Currently, many patients do not comply with their scheduled annual fundus revision owing to the burden of work that affects to the Ophtalmology Services. The use of the non-mydriatic retinograph could represent an effective alternative for screening the DR because of the time save, non-requering an ophtalmologist, and therefore contributing to shortenning the waiting lists. Nevertheless, this camera should not be regarded as a technique that would replace comprehensive eye examinations but as an adjunct to the traditional care.