title: Sight-threatening diabetic retinopathy at presentation to screening services in Fiji.
abstract: OBJECTIVE
  To report the spectrum of retinopathy at first presentation to photoscreening services, to determine the proportion of patients that present with sight-threatening diabetic retinopathy (STDR), and to raise awareness of the burden of diabetic eye disease in Fiji.
  
  
  METHODS
  This retrospective observational cohort study used data from the initial visit of all new patients presenting to the diabetes retinal screening service at the Pacific Eye Institute in Fiji over the 3-month period between July and September 2012. Patients were assessed using a detailed questionnaire regarding diabetes type, duration of disease, medications, complications and co-morbidities, and blood sugar control. Patients subsequently underwent non-mydriatic fundus photography according to Pacific diabetes retinal screening guidelines. Images were graded at the time of acquisition, and data were entered onto a computerized database. For the purposes of this study, information regarding retinopathy grading, visual acuity and patient demographics was used.
  
  
  RESULTS
  A total of 522 new patients were screened over the 3-month period. STDR was observed in 27% of patients, with 15% observed to have bilateral STDR. Diabetes control was generally poor. Blindness and visual impairment were observed in 2.7% and 6.7% of the cohort, respectively.
  
  
  CONCLUSIONS
  Severe and advanced diabetic retinopathy was present in this population presenting to screening. This was observed 4 years after the formal expansion of the screening services and reflects the high prevalence of diabetes in the population. The need for increased public awareness and greater resource allocation into diabetes and its complications is emphasized.
authors.affiliation: Fred Hollows Foundation , Newmarket, Auckland , New Zealand .
authors.forename: Erika M
authors.initials: EM
authors.lastname: Damato
authors.forename: Neil
authors.initials: N
authors.lastname: Murray
authors.forename: John
authors.initials: J
authors.lastname: Szetu
authors.forename: Biu Telaite
authors.initials: BT
authors.lastname: Sikivou
authors.forename: Stephanie
authors.initials: S
authors.lastname: Emma
authors.forename: Charles N J
authors.initials: CN
authors.lastname: McGhee
mesh_terms: D000328:Adult; D000368:Aged; D001766:Blindness / Q000145:classification / Q000175:diagnosis* / Q000453:epidemiology; D001786:Blood Glucose / Q000378:metabolism; D003922:Diabetes Mellitus, Type 1 / Q000175:diagnosis; D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis; D003930:Diabetic Retinopathy / Q000145:classification / Q000175:diagnosis* / Q000453:epidemiology; D005260:Female; D005367:Fiji / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010781:Photography; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D015351:Vision Screening; D015354:Vision, Low / Q000145:classification / Q000175:diagnosis* / Q000453:epidemiology; D014792:Visual Acuity / Q000502:physiology
chemical_list: D001786:Blood Glucose
keywords: Diabetic retinopathy; Pacific; diabetic retinopathy screening; sight-threatening