Clinical biomicroscopy versus fluorescein angiography: effectiveness and sensitivity in detecting diabetic retinopathy.

PURPOSE: To compare diagnostic effectiveness and sensitivity of the two methods of screening for diabetic retinopathy. METHODS: Prospective analytic study comparing diabetic retinopathy grading obtained from clinical slit lamp biomicroscopy and fundus fluorescein angiography (FFA). A total of 189 consecutive patients were examined in the ophthalmology department at Jordan University Hospital. RESULTS: A total of 376 eyes were reviewed by consultant ophthalmologist for diabetic retinopathy grading on FFA. The sensitivity of ophthalmoscopy in diagnosing diabetic retinopathy grading was 91.2%, with a specificity of 97.9%. The degree of agreement kappa was 0.87. CONCLUSIONS: Slit-lamp biomicroscopy is highly sensitive for screening diabetic retinopathy grading in diabetic patients and ophthalmologists do not need to confirm a suspected clinical diagnosis of proliferative diabetic retinopathy using FFA as ophthalmoscopy proved to be comparable to angiography.

Prevalence of blindness and visual impairment among Jordanian diabetics.

PURPOSE: To investigate the prevalence of blindness and visual impairment among a population of Jordanian diabetics. METHODS: A total of 986 diabetic patients were fully assessed, including complete history, examination, and laboratory tests. All patients underwent detailed eye examination, which included visual acuity, slit-lamp examination, tonometry, funduscopy, and fundus fluorescein angiography (FFA). RESULTS: Of all patients examined, 53.2% were male and 46.8% were female. The mean age and duration of diabetes were 55.3 and 11.9 years. Of all patients, 93.3% had type 2 while 6.7% had type 1 diabetes mellitus (DM). Over half (50.3%) were on oral hypoglycemic agents, 34% on insulin, and 14.5% on both types of treatment, whereas only 1.2% were on diet alone. The mean value for HbA1c was 7.7%. The prevalence of blindness among participants was found to be 7.4%, while 10.1% were visually impaired. Diabetic retinopathy (DR) was present in 64.1%, 37.8% had cataract, and 8.7% had undergone cataract surgery. Using multivariate logistic regression analysis, visual impairment was significantly associated with age, treatment of diabetes, and DR, while only age and retinopathy were significantly related to blindness. CONCLUSIONS: DM is a common disease in Jordan and DR is highly prevalent among Jordanian diabetics. National screening and educational programs are highly needed to reduce the risk of blindness and visual impairment among diabetic patients.

Causes of blindness among adult Jordanians: a hospital-based study.

PURPOSE: To assess the causes of blindness among adults aged 20 years and over who attended two big general ophthalmic clinics in Jordan. PATIENTS AND METHODS: This hospital-based study was undertaken at Jordan University Hospital in Amman (the capital of Jordan) and Princess Basma Teaching Hospital which is affiliated with Jordan University of Science and Technology in Irbid, the third largest city in the country. A total of 2732 patients seen consecutively over 26 months were examined and the ophthalmic findings were recorded. Using standard Snellen charts, subjects were placed in one of three categories according to their best corrected visual acuity: (1) unilateral blindness: less than 6/60 in the worst eye, 6/60 or more in the better eye; (2) moderate bilateral blindness: less than 6/60 in the worst eye, less than 6/60 to 3/60 or more the better eye; and (3) severe bilateral blindness: less than 3/60 in both eyes. RESULTS: Of the totalpatients seen, 373 were blind according to the selection criteria. Among 248 patients with unilateral blindness, diabetic retinopathy, cataract and trauma were the leading causes. Among the 81 patients with moderate bilateral blindness, diabetic retinopathy and cataract were the leading causes. Diabetic retinopathy and glaucoma were the leading causes in patients with severe bilateral blindness. CONCLUSIONS: These data could be used in planning blindness prevention and treatment programs while awaiting a national survey on the prevalence and causes of blindness in Jordan.