title: Prevalence of diabetic retinopathy at first presentation to the retinal screening service in the greater Wellington region of New Zealand 2006-2015, and implications for models of retinal screening.
abstract: OBJECTIVE
  To describe the prevalence of diabetic retinopathy (DR) in patients at first presentation for diabetic retinal screening in the greater Wellington region with the intent of service evaluation.
  
  
  METHODS
  This is a retrospective study using data collected from patients newly referred for diabetic retinal screening between 2006-2015 (prevalence analysis, n=12667). The prevalence of DR was calculated by gender, ethnicity, age, type of diabetes and glycaemic control (HbA1c). Chi-square test and multiple logistic regression was used for data analysis.
  
  
  RESULTS
  The prevalence of any DR was 22.5% (n=2852) (non-sight-threatening (NST-DR) n=2562, 20.2%, sight-threatening (ST-DR) n=290, 2.3%). Type 1 diabetes and poor HbA1c control were strongly associated with any degree of DR. Old-age (>65 years), and Asian and Pacific Island (PI) ethnicity had moderately greater odds compared with European. Male gender had marginally increased odds for any DR.
  
  
  CONCLUSIONS
  This study identified a large proportion (97.7%) of patients (no DR n=9815, 77.5%, NST-DR n=2562, 20.2%) who can be managed in the community by appropriately supported primary care providers, and do not require referral to secondary care ophthalmology. In addition to early detection of ST-DR (2.3%), retinal screening is an early opportunity for education of patients with no DR or NST-DR.
authors.affiliation: School of Optometry & Vision Science, University of Auckland, Auckland.
authors.forename: Lily Yl
authors.initials: LY
authors.lastname: Chang
authors.affiliation: Section of Epidemiology and Biostatistics, School of Population Health, University of Auckland, Auckland.
authors.forename: Arier C
authors.initials: AC
authors.lastname: Lee
authors.affiliation: Bentley & Sue Optometrists, Upper Hutt Wellington.
authors.forename: Wilson
authors.initials: W
authors.lastname: Sue
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D002648:Child; D003695:Delivery of Health Care; D003922:Diabetes Mellitus, Type 1 / Q000453:epidemiology* / Q000517:prevention & control; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology* / Q000517:prevention & control; D003930:Diabetic Retinopathy / Q000453:epidemiology* / Q000517:prevention & control; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009520:New Zealand / Q000453:epidemiology; D015995:Prevalence; D012189:Retrospective Studies; D017678:Sex Distribution; D015351:Vision Screening; D055815:Young Adult