Risk Factor Analysis of Diabetic Retinopathy Diagnosed with Non-mydriatic Fundus Camera: KNHANES V

PURPOSE: To clarify the relationship between various factors (sociodemographic factors, health behavioral risk factors and health status, and diabetic factors) related to diabetic retinopathy and to suggest improvements regarding the associated medical examination. METHODS: The subjects were 1,444 diabetic patients diagnosed in the 5th Korean National Health and Nutrition Examination Survey (KNHANES), aged 19 years or older, who underwent non-mydriatic fundus photography. The criteria for diagnosing diabetes were a fasting glucose level ≥ 126 mg/dL and a previous diagnosis of diabetes or currently undergoing treatment. The diagnosis of diabetic retinopathy followed the modified Airlie House classification. Univariate and multivariate analyses of diabetic retinopathy were performed. RESULTS: Among the 1,444 patients who were diagnosed with diabetes, 277 had diabetic retinopathy; the prevalence rate was 19.18%. The higher the body mass index, the lower the risk of diabetic retinopathy by 0.924 times (p = 0.001; 95% confidence interval [CI], 0.883–0.966). The longer the duration of diabetes, the greater the risk of diabetic retinopathy; the prevalence period group of more than 11 years had a 26.025-fold higher risk than the newly diagnosed group (p < 0.001; 95% CI, 10.840–62.482). The risk of diabetic retinopathy increased with the hemoglobin A1c (HbA1c) level; the risk was 5.973-fold higher in the group with HbA1c above 11.0% (p < 0.001; 95% CI, 2.984–11.956) compared with the group with HbA1c < 6.0%. The risk of diabetic retinopathy was 2.050-fold greater with insulin injections (p = 0.003; 95% CI, 1.284–3.275). CONCLUSIONS: The risk of diabetic retinopathy was higher in patients with a longer duration of diabetes, a high HbA1c level, and in those using insulin. These findings highlight the need for early education and ophthalmologic examinations for at-risk patients.

Clinical significance of non - mydriatic fundus photography in screening for preschool children ocular fundus disease / 国际眼科杂志(Guoji Yanke Zazhi)

AIM:To observe the incidence of ocular fundus disease in preschool children examined by non-mydriatic fundus camera and evaluate its effectiveness compared with direct inspection shadow mirror. METHODS: Three thousand eight hundred and ninety-six preschool children from April 2012 to October 2013 were examined by Topcon TRC-NW300 color fluorescence fundus camera and direct inspection shadow mirror, and images were saved immediately. RESULTS: Detection rate of non - mydriatic fundus photography was higher than that of direct inspection shadow mirror. In 3 896 cases, 41 eyes were detected abnormal fundus accounting for 1. 05%. The retinal myelinated nerve fibers, morning glory syndrome, retinitis pigmentosa, congenital retinoschisis were common, accounted for 24. 39%, 21. 95%, 14. 63%, 12-20% respectively. The children eye diseases were often accompanied by abnormal vision (68. 30%), ametropia (63. 41%), strabismus (19. 51%). CONCLUSION:Non-mydriatic fundus photography is a mydriatic method without medicine, so it is easy for preschool children to accept. Image results could directly display the fundus lesions. It shows important significance in the screening for preschool children eye diseases.

A new method of cataract imaging evaluation / 眼科

Photography of slit-lamp biomicroscopy combined with retro-illumination photography is the gold standard in cataract evaluation. However the application is limited due to its complexity and low efficiency. We introduce digital non-mydriatic fundus photography as a new method for cataract screening in patients with visual impairment,which might play an important role in screening low vision and blindness caused by cataract. Two distinguished benefits are found in this method including compatibility for tele-diagnosis,and integration with screening of glaucoma and diabetic retinopathy. Cautions should be made on the photographs in which media opacity derived from other than cataract or low quality photos due to small pupils.