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

dc.contributor.authorWebb, Elizabeth M.
dc.contributor.authorRheeder, Paul
dc.contributor.authorRoux, Polla
dc.contributor.emailelize.webb @ up.ac.zaen_ZA
dc.date.accessioned2016-11-14T13:16:43Z
dc.date.available2016-11-14T13:16:43Z
dc.date.issued2016-03-10
dc.description.abstractOBJECTIVE : 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.departmentInternal Medicineen_ZA
dc.description.departmentOphthalmologyen_ZA
dc.description.departmentSchool of Health Systems and Public Health (SHSPH)en_ZA
dc.description.librarianam2016en_ZA
dc.description.sponsorshipThe 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.uriwww.karger.com/ophen_ZA
dc.identifier.citationWebb, 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.issn0030-3755 (print)
dc.identifier.issn1423-0267 (online)
dc.identifier.other10.1159/000443972
dc.identifier.urihttp://hdl.handle.net/2263/58059
dc.language.isoenen_ZA
dc.publisherKarger Publishersen_ZA
dc.rights© 2016 S. Karger AG, Baselen_ZA
dc.subjectDiabetes screeningen_ZA
dc.subjectDiabetes complicationsen_ZA
dc.subjectDiabetic retinopathyen_ZA
dc.subjectDiabetic maculopathyen_ZA
dc.subjectVisual acuityen_ZA
dc.subjectTeleophthalmologyen_ZA
dc.titleScreening in primary care for diabetic retinopathy, maculopathy and visual loss in South Africaen_ZA
dc.typeArticleen_ZA

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