Frequency, severity and risk indicators of retinopathy in patients with diabetes screened by fundus photographs: a study from primary health care.
OBJECTIVE
To determine the frequency, severity and risk indicators of diabetic retinopathy (DR) in patients with diabetes attending a primary care diabetes centre.


METHODS
This observational study was conducted at Diabetic Association of Pakistan - a World Health Organization collaborating center in Karachi, from March 2009 to December 2011. Registered patients with diabetes were screened by two field fundus photographs. Retina specialists graded the signs of retinopathy according to diabetic retinopathy disease severity scale.


RESULTS
Of total registered diabetic patients (n=11,158), 10,768 (96.5 %) were screened for DR. Overall DR was found in 2661 (24.7%) patients. DR was found in decreasing order of frequency in patients with type 2 (n= 2555, 23.7%) followed by patients with type 1 diabetes (n=101, 0.93% ) and patients with gestational diabetes mellitus (GDM) (n=5, 0.46%). Among patients with DR, signs of non-sight threatening retinopathy was dominant. Females and patients of working age group predominantly had retinopathy. Type 1 patients >16 years and type 2 patients < 5 years of history of diabetes had sign of retinopathy in increased frequency.


CONCLUSIONS
Every forth patient with diabetes in this large cohort had signs of diabetic retinopathy. Females and patients in working age group predominantly had retinopathy. Type 2 patients with short while type 1 patients with long history of diabetes most frequently had DR. Dissemination of the present study findings may help in increasing the awareness of this serious complication of diabetes.
Saleh Memon, FRCS, Director Projects, Community Based Projects, Al Ibrahim Eye Hospital, ISRA postgraduate Institute of Ophthalmology, Gadap Town, Malir Karachi-75040, Pakistan.
Saleh
S
Memon
Shahid Ahsan, MBBS, MPhil, Assistant Professor, Dept. of Biochemistry, Hamdard College of Medicine and Dentistry, Hamdard University, Karachi, Pakistan.
Shahid
S
Ahsan
Qamar Riaz, MBBS, M.Sc , Course Supervisor, ISRA School of Optometry, Al Ibrahim Eye Hospital, ISRA postgraduate Institute of Ophthalmology, Gadap Town, Malir Karachi-75040, Pakistan.
Qamar
Q
Riaz
Abdul Basit, FRCP, Professor of Medicine, Department of Medicine, Baqai Institute of Diabetology and Endocrinology, Baqai Medical University, Plot No. 1-2, II-B, Nazimabad No2, Karachi-74600, Pakistan.
Abdul
A
Basit
Sikandar Ali Sheikh, M.A ,Diploma in Diabetes Education, Project Manager, Community Based Projects, Al Ibrahim Eye Hospital, ISRA postgraduate Institute of Ophthalmology, Gadap Town, Malir Karachi-75040, Pakistan.
Sikandar
S
Ali Sheikh
Asher Fawwad, M.Phil, Assistant Professor, Research Department, Baqai Institute of Diabetology and Endocrinology, Baqai Medical University, Plot No. 1-2, II-B, Nazimabad No2, Karachi-74600, Pakistan.
Asher
A
Fawwad
A Samad Shera, FRCP, Director WHO Collaborating Centre, Diabetic Association of Pakistan, 5-E / 3, Nazimabad, Karachi-74600, Pakistan.
A Samad
AS
Shera
Diabetic retinopathy; Fundus camera; Primary care diabetes centre