Screening in primary care for diabetic retinopathy, maculopathy and visual loss in South Africa

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dc.contributor.author Webb, Elizabeth M.
dc.contributor.author Rheeder, Paul
dc.contributor.author Roux, Polla
dc.date.accessioned 2016-11-14T13:16:43Z
dc.date.available 2016-11-14T13:16:43Z
dc.date.issued 2016-03-10
dc.description.abstract OBJECTIVE : The aim of the study was to determine the prevalence of diabetic retinopathy, maculopathy and visual loss in primary care patients and to identify associated risk factors. RESEARCH DESIGN AND METHODS : We conducted a cluster randomised trial at primary care clinics in the Tshwane district in South Africa. Grades of retinopathy and maculopathy (with fundus camera) and visual acuity (Snellen chart) were assessed and, using mobile screening and teleophthalmology, clinical and biochemical testing was conducted to obtain information about glycaemic control and microvascular complications. RESULST : The prevalence rates for any retinopathy, preproliferative retinopathy and proliferative retinopathy were 24.9, 19.5 and 5.5%, respectively. The prevalence rates of diabetic maculopathy, observable maculopathy and referable maculopathy were 20.8, 11.8 and 9.0%, respectively. The presence of retinopathy was associated with high body mass index, systolic blood pressure, being on insulin treatment, high HbA1c and the presence of neuropathy. High systolic blood pressure, being on insulin treatment, high HbA1c level and high low-density lipoprotein choles- terol level as well as the presence of albuminuria were significant in predicting any diabetic maculopathy. Laser photocoagulation was given to 8.3% of patients from the mobile unit and 12% of patients were referred to the nearest hospital with an outpatient eye clinic for follow-up treatment of various other eye conditions. Using the WHO categories, the study found that 78.1% of diabetes patients had normal vision, 19.3% were visually impaired and 2.2% were severely impaired or blind. CONCLUSION : High prevalence rates for diabetic retinopathy, maculopathy and visual loss were found and associations were identified. en_ZA
dc.description.department Internal Medicine en_ZA
dc.description.department Ophthalmology en_ZA
dc.description.department School of Health Systems and Public Health (SHSPH) en_ZA
dc.description.librarian am2016 en_ZA
dc.description.sponsorship The Society for Endocrinology, Metabolism and Diabetes of South Africa (SEMDSA), the African Population & Health Research Centre (APHRC) and research funds from the University of Pretoria. en_ZA
dc.description.uri www.karger.com/oph en_ZA
dc.identifier.citation Webb, EM, Rheeder, P & Roux, P 2016, 'Screening in primary care for diabetic retinopathy, maculopathy and visual loss in South Africa', Ophthalmologica, no. 235, pp. 141-149. en_ZA
dc.identifier.issn 0030-3755 (print)
dc.identifier.issn 1423-0267 (online)
dc.identifier.other 10.1159/000443972
dc.identifier.uri http://hdl.handle.net/2263/58059
dc.language.iso en en_ZA
dc.publisher Karger Publishers en_ZA
dc.rights © 2016 S. Karger AG, Basel en_ZA
dc.subject Diabetes screening en_ZA
dc.subject Diabetes complications en_ZA
dc.subject Diabetic retinopathy en_ZA
dc.subject Diabetic maculopathy en_ZA
dc.subject Visual acuity en_ZA
dc.subject Teleophthalmology en_ZA
dc.title Screening in primary care for diabetic retinopathy, maculopathy and visual loss in South Africa en_ZA
dc.type Article en_ZA


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