RESUMEN
Purpose: To determine the feasibility of telemedicine screening for diabetic retinopathy in a community setting and to determine the prevalence of diabetic retinopathy among Filipino patients with type 2 diabetes in the community. Study Design: Cross-sectional study among patients with type 2 diabetes in six community health centers in an urban city in the Philippines. Materials and methods: Subjects were examined from November 2018 to December 2018. A three-field non-mydriatic 45’ fundus photographs were taken for each patient and photographs were uploaded in cloud storage and read by a retina specialist in a tertiary hospital for assessment of diabetic retinopathy and grading of the fundus photographs. The results were sent back to local health centers. Results: A total of 387 eyes of 195 persons were examined. Overall, 288 out of 387 eyes (95.36%) had gradable quality fundus photo (grade 3 and higher) and did not need eye dilation. Prevalence of diabetic retinopathy among the respondents was 25.26% - 3.16% had mild diabetic retinopathy, 15.79% had moderate diabetic retinopathy, 3.68% had severe diabetic retinopathy, and 3.68% had proliferative diabetic retinopathy. Other fundus findings noted include hypertensive retinopathy glaucomatous optic nerve, age-related macular degeneration, posterior vitreous detachment, clinically significant macular edema, and epiretinal membrane. Conclusion: Due to the significant number of patients with diabetic retinopathy among type 2 diabetics in the community, telemedicine screening was a feasible alternative to dilated fundus examination and may be considered as part of the local health program to prevent blindness due to diabetes.
RESUMEN
Purpose@#To determine the feasibility of telemedicine screening for diabetic retinopathy in a community setting and to determine the prevalence of diabetic retinopathy among Filipino patients with type 2 diabetes in the community. @*Study Design@#Cross-sectional study among patients with type 2 diabetes in six community health centers in an urban city in the Philippines. @*Materials and methods@#Subjects were examined from November 2018 to December 2018. A three-field non-mydriatic 45’ fundus photographs were taken for each patient and photographs were uploaded in cloud storage and read by a retina specialist in a tertiary hospital for assessment of diabetic retinopathy and grading of the fundus photographs. The results were sent back to local health centers. @*Results@#A total of 387 eyes of 195 persons were examined. Overall, 288 out of 387 eyes (95.36%) had gradable quality fundus photo (grade 3 and higher) and did not need eye dilation. Prevalence of diabetic retinopathy among the respondents was 25.26% - 3.16% had mild diabetic retinopathy, 15.79% had moderate diabetic retinopathy, 3.68% had severe diabetic retinopathy, and 3.68% had proliferative diabetic retinopathy. Other fundus findings noted include hypertensive retinopathy glaucomatous optic nerve, age-related macular degeneration, posterior vitreous detachment, clinically significant macular edema, and epiretinal membrane.@*Conclusion@#Due to the significant number of patients with diabetic retinopathy among type 2 diabetics in the community, telemedicine screening was a feasible alternative to dilated fundus examination and may be considered as part of the local health program to prevent blindness due to diabetes.
RESUMEN
@#<p style="text-align: justify;"><strong>OBJECTIVE:</strong> The aim of the study was to determine the prevalence of diabetic patients seeking an ophthalmic evaluation for diabetic retinopathy. Specific objectives were to describe the prevalence and risk factors for diabetic retinopathy (DR) in a group of diabetic patients referred for retinal evaluation from different internists in Laguna by screening using digital retinal photography.</p> <p style="text-align: justify;"><strong>METHODS:</strong> The study was a hospital-based mixed method study involving two portions: quantitative (cross-sectional) and qualitative. The cross-sectional portion involved patients diagnosed with type 2 diabetes by internists from San Pablo Colleges Medical Center referred for retinal evaluation using a non-mydriatic retinal camera. Retinal photographs were categorised for the presence and severity of diabetic retinopathy according to the international clinical DR severity scales recommended by the Global Diabetic Retinopathy Project Group. The qualitative portion involved a focus group discussion among diabetic patients and a short key informant interview with the referring internists.</p> <p style="text-align: justify;"><strong>RESULTS:</strong> Sixty-seven (67) diabetic patients were evaluated for diabetic retinopathy (DR) using digital retinal photography. The overall prevalence of any DR was 26% (n=18): 55% mild NDPR, 33% moderate NDPR, 6% severe NPDR and 6% PDR. Diabetic macular edema (DME) was present in 22% of patients with any form of DR. The focus group discussion reported the following reasons for consulting an ophthalmologist: presence of blurring of vision, availability of budget, knowledge of the need for ophthalmic evaluation, and order for evaluation by the internist. Interviews among the referring internists revealed three primary reasons for referring: history of visual disturbances, uncontrolled diabetes and finances of the patient.</p> <p style="text-align: justify;"><strong>CONCLUSION:</strong> This study presented a lower prevalence rate of diabetic retinopathy among patients who underwent digital retinal photography compared to that of other studies published in the Philippines. Nevertheless, it is important to continue patient education with regards to diabetic complications in the eye, and improve the referral system among medical practitioners.</p>