Fundus Camera as a Screening for Diabetic Retinopathy in AMC Yogyakarta Indonesia (original) (raw)
Related papers
BMC Ophthalmology
Background This study aimed to assess the prevalence and associated factors of diabetic retinopathy (DR) and vision threatening DR (VTDR) among people with diabetes screened using fundus photography in Nepal. Methods This is a retrospective study among people with diabetes presented for DR screening using fundus photography from 2013 to 2019. Detailed demographics, duration of diabetes, medical history, visual acuity, and grading of DR on fundus photography were analyzed. Fundus camera used in the study were;Topcon digital fundus camera 900 CXR and digital portable fundus cameras (Nidek-10 portable non-mydriatric fundus camera; Versacam & Trade & Alpha, France), and a Zeiss portable fundus camera (Zeiss Visucout 100). Macula centred and disc centred 45 degree two images were taken from each eye. Pupil were dilated in cases where there was media haze in un-dilated cases. DR was graded using early treatment diabetic retinopathy study criteria. The images were graded by fellowship trai...
International Journal of Health Services Research and Policy, 2020
Purpose: Early identification of patients at risk for diabetes mellitus (DM) and associated morbidities such as diabetic retinopathy (DR) is essential for effective lifestyle intervention and treatment. Large-scale, cost-effective and minimally invasive screening programs are critical for this purpose. This study evaluated the prevalence and history-based risk factors for DR and whether the non-mydriatic fundus camera is an effective screening method in Turkey at local health centers. Methods: A total of 5182 adults 40 years and older were invited to local health centers in rural Eskisehir, Turkey, for DR risk factor assessment and screening by fundus examination. Fundal images were graded on-site by trained ophthalmology assistants for DR and diabetic macular edema (DME). Patients with DR and DME were referred to the tertiary center for follow-up. Results: The severity of DR was associated with female sex, older age, longer duration of DM, insulin usage, lower body mass index (BMI)...
Clinical Ophthalmology, 2010
To compare the results obtained by two screening techniques for diabetic retinopathy. Methods: Patients were assessed in two groups, according to whether the retinal images were analyzed by the general practitioner (Group 1) or by the ophthalmologist (Group 2) in a two-year prospective study using telemedicine. Results: The number of patients referred to the nonmydriatic fundus camera unit was higher in Group 1 than in Group 2 (63.80% versus 17.63%). Greater patient adherence was observed in Group 1 than in Group 2 when patients came to retinography (98.25% versus 87.52%). There were no significant differences in other technique variables. The prevalence of diabetic retinopathy was similar in both groups (8.98% in Group 1 and 9.16% in Group 2), but the prevalence of severe proliferative diabetic retinopathy was higher in Group 2 (1.69% [severe] and 0.45% [proliferative]) than in Group 1 (1.01% and 0.11%, respectively). Diabetic macular edema was more prevalent in Group 2 (2.03%). Conclusions: The inclusion of general practitioners in the screening method seems to be important. A great number of patients with diabetes mellitus were screened, and a higher percentage of patients with diabetic retinopathy or macular edema were detected.
This study aims to evaluate the risk indicators of diabetic retinopathy in patients with type 2 diabetes screened by fundus photographs at a tertiary care diabetes centre in Karachi, Pakistan. A cross-sectional study was conducted at the outpatient department of Baqai Institute of Diabetology and Endocrinology from October 2009 to March 2010. Patients ≥30 years of age were recruited randomly. Demographic, anthropometric, clinical and biochemical data were collected, and ophthalmic screening was done by two field fundus photography. Fundus photographs of 366 patients were graded according to the modified Early Treatment Diabetic Retinopathy Disease Severity Scale (ETDR S) criteria. Retinopathy was present in 27.3 % patients. Fifteen percent of patients had non-sight-threatening retinopathy while 12 % had sight-threatening retinopathy. Patients with retinopathy had significantly increased mean duration of diabetes, systolic and diastolic blood pressure and HbA1c (p<0.001). Patients with sight-threatening retinopathy also had increased serum cholesterol (p<0.05) and serum creatinine (p<0.001). Multivariate logistic regression revealed male gender (3.5 times, 95 % confidence interval (CI); 1.73-7.12), increased duration of diabetes (≥10 years, 5.46 times, 95 % CI; 2.15-13.85), hypertension (≥130/85, 1.96 times, 95 % CI; 0.95-4.03) and poor glycemic control (HbA1c ≥7 %, 1.39 times, CI; 1.23-1.56) as significant factors for developing retinopathy. Diabetic retinopathy was present in every fourth subject, while sight-threatening retinopathy was present in every eighth subject with type 2 diabetes. The results of the present study highlight the importance of screening for retinopathy. The identification of risk indicators associated with retinopathy in our population may lead to measures of prevention of sight-threatening complication of diabetes. Fundus photographs revealed increased frequency of retinopathy among patients with type II diabetes. Male gender, increased mean duration of diabetes, hypertension and poor glycemic control related with the presence of retinopathy, while increased serum cholesterol and creatinine related with severity of retinopathy. The present study highlights the importance of screening for retinopathy. The presence and severity of retinopathy in this population was attributed to the factors identified in earlier studies. The present study thus validated the findings of studies conducted on diverse populations across the world.
Diabetes Therapy
Introduction: We aimed to determine the prevalence and risk factors for diabetic retinopathy (DR) in a multi-primary healthcare facilities-based DR screening project by analyzing single-field fundus photographs among patients with diabetes in Rafsanjan City, Iran, based on the Rafsanjan Cohort Study, as a part of the prospective epidemiological research studies in IrAN (PERSIAN). Methods: Of all participants in the Rafsanjan Cohort Study (performed in four primary healthcare facilities across Rafsanjan City from August 2015 to December 2017), patients with diabetes were recruited in this study. All participants underwent a standardized interview and clinical and paraclinical examinations for demographic characteristics, and medical conditions according to the PERSIAN's protocols. In addition, digital fovea-centered and single-field fundus photography was performed for DR identification and grading. For assessment of agreement, a subgroup of participants underwent fundus examination, randomly. DR was graded as nonproliferative (NPDR) or proliferative (PDR). Results: Of 8414 screened participants, 1889 had diabetes. The total prevalence of DR was 6.93% [131 individuals including 110 (5.82%) with NPDR, and 21 (1.11%) with PDR] based on single-field fundus photographs, with almost perfect agreement with fundus examinations (j = 0.82). On adjusted multivariate analysis, duration of diabetes (OR 1.16, 95% CI 1.13-1.19), positive family history for diabetes (OR 1.73, 95% CI 1.09-2.75), fasting plasma glucose (FPG) C 126 mg/dL (OR 1.98, 95% CI 1.16-3.39), and serum creatinine level (OR 1.79, 95% CI 1.08-2.98) were associated with DR. Factors including age, education level, physical activity, body mass index, hypertension, and cardiovascular and renal diseases did not have association with DR on adjusted multivariate analysis. Conclusions: Single-field fundus photography can be used for screening of DR in primary healthcare facilities. In individuals with diabetes, duration of diabetes, positive family history for diabetes, FPG C 126 mg/dL, and serum creatinine level may be associated with DR.
JAMA Network Open, 2019
ImportanceDiabetic retinopathy (DR) is the leading cause of low vision among working-age adults. An estimated 6.9 million people in Bangladesh were living with diabetes in 2017, which is projected to increase to more than 10 million people in 2025. Currently, no standardized and/or large-scale DR screening program exists in Bangladesh.ObjectiveTo develop a novel fundus photograph–based eye screening model for early detection of DR to prevent vision loss in Bangladeshi individuals with diabetes.Design, Setting, and ParticipantsIn this cross-sectional study, 49 264 patients with diabetes underwent opportunistic eye screening at 2 eye hospitals and 1 diabetic hospital in Bangladesh between June 1, 2010, and September 30, 2017. The data set was analyzed from April 8 to December 30, 2018. Technicians were trained to obtain 2-field digital fundus photographs and to grade each according to a standardized DR severity scale. Each patient was counseled and triaged for treatment using defined DR referral criteria.Main Outcomes and MeasuresPrimary DR grading outcomes, visual acuity, and treatment outcomes.ResultsA total of 49 264 patients (54.3% male; mean [SD] age, 50.8 [12.3] years) underwent DR screening during a 7-year period. The DR prevalence rate across all 3 sites was 33% (95% CI, 33%-33%). Prevalence rates varied by center (Chittagong, 64.6% [95% CI, 64.0%-65.0%]; Dhaka, 39.8% [95% CI, 39.0%-41.0%]; and Feni, 13.0% [95% CI, 13.0%-14.0%]). Across all age groups, male patients were at higher risk of prevalent DR than female patients (odds ratio, 1.99; 95% CI, 1.90-2.07). The prevalence was 3.9% for preproliferative DR, 7.8% for proliferative DR, and 19.2% for maculopathy. Individuals with DR had significantly worse visual acuity than those with no DR (best-corrected visual acuity, 0.35 vs 0.21 logMAR; P < .001). The rate of moderate visual impairment was 12.2%, and the rate of blindness was 2.5%. Primary treatments included laser photocoagulation (n = 1637), intravitreal injection (n = 1440), and vitrectomy (n = 309).Conclusions and RelevanceScreening Bangladeshi individuals known to have diabetes using fundus photography identified large numbers of patients with sight-threatening proliferative DR, maculopathy, and visual impairment or blindness. Expansion of eye screening services in Bangladesh is warranted as part of a national government eye care and diabetes health policy.
2019
OBJECTIVE To determine the diagnostic accuracy of non-mydriatic fundus camera for the detection of diabetic retinopathy. METHODS The cross-sectional study was conducted at Al Ibrahim Eye Hospital, Karachi, from January to May 2015, and comprised patients with type 2 diabetes who were screened for diabetic retinopathy. Single 45° fundus image focussed at macula was obtained and labelled using non-mydriatic fundus camera by a trained optometrist. Photos were labelled as positive (diabetic retinopathy present), negative (no diabetic retinopathy) or unreadable. The pupil was then dilated and fundi were examined by ophthalmologist with slit-lamp and fundus lens. Results of fundus examination were labelled as positive, negative or invisible/indecisive. Results of ophthalmologist were taken as the standard reference to evaluate sensitivity and speci?city for detecting diabetic retinopathy with non-mydriatic fundus camera. SPSS 20 was used for data analysis. RESULTS Total eyes screened numb...
Screening for diabetic retinopathy in rural area using single-field, digital fundus images
Journal of the Medical Association of Thailand Chotmaihet Thangphaet, 2005
To evaluate the practicability of using single-field, 2.3 million-pixel, digital fundus images for screening of diabetic retinopathy in rural areas. Material and Method: All diabetic patients who regularly attended the diabetic clinic at Kabcheang Community Hospital, located at 15 kilometers from the Thailand-Cambodia border, were appointed to the hospital for a 3-day diabetic retinopathy screening programme. The fundi of all patients were captured in single-field, 45 , 2.3 million-pixel images using nonmydriatic digital fundus camera and then sent to a reading center in Bangkok. The fundi were also examined through dilated pupils by a retinal specialist at this hospital. The grading of diabetic retinopathy from two methods was compared for an exact agreement. Results: The average duration of single digital fundus image capture was 2 minutes. The average file size of each image was 750 kilobytes. The average duration of single image transmission to a reading center in Bangkok via satellite was 3 minutes; via a conventional telephone line was 8 minutes. Of all 150 patients, 130 were assessed for an agreement between dilated fundus examination and digital fundus images in diagnosis of diabetic retinopathy. The exact agreement was 0.87, the weighted kappa statistics was 0.74. The sensitivity of digital fundus images in detecting diabetic retinopathy was 80%, the specificity was 96%. For diabetic macular edema the exact agreement was 0.97, the weighted kappa was 0.43, the sensitivity was 43%, and the specificity was 100%. Conclusion: The image capture of the nonmydriatic digital fundus camera is suitable for screening of diabetic retinopathy and single-field digital fundus images are potentially acceptable tools for the screening. The real-time image transmission via telephone lines to remote reading center, however, may not be practical for routine diabetic retinopathy screening in rural areas.