Detection of retinopathy by non-mydriatic fundus photography in diabetics treated with oral hypoglycaemic agents or diet

Abstract

Objective — To determine the prevalence of retinopathy by non-mydriatic fundus photography in diabetics treated with oral hypoglycaemic agents or diet.

Design — Cross-sectional survey of diabetes-induced fundal changes assessed by fundus photography.

Setting — Area of Health Centre of Oulu. Population 100000.

Subjects — All 1228 diabetic patients, aged 30 years or over and treated with oral hypoglycaemic agents or diet at the Health Centre of Oulu.

Main outcome measures — Presence and severity of diabetic retinopathy in fundus photographs, need for laser photocoagulation, age, hypertension, body mass index (BMI), duration of diabetes, type of treatment of diabetes.

Results — Retinopathy was observed in 178 (18 %) of those 1015 diabetics examined at the health centre. Retinopathic changes requiring laser treatment were observed in 15 cases, and eight of them had not been diagnosed earlier. Sixty non-attenders photographed at the Central University Hospital were also included, and 12 of them had retinopathy. The presence of retinopathy was associated with long duration of diabetes, poor glycaemic control, and high systolic blood pressure. No association was detected with sex, age at onset of diabetes, BMI, medication for coronary artery disease, or hypertension.

Conclusions — Non-mydriatic fundus photography detected a high prevalence of retinopathy in diabetic patients. Half of those with preproliferative changes were previously undiagnosed cases, and five were in need of immediate laser treatment. It is concluded that fundus photography is a useful tool for detecting retinopathy in a primary health care setting.

Key Words:

• diabetic retinopathy
• type 2 diabetes
• non-mydriatic fundus photography