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Developing a Screening Program to Detect Sight-Threatening Diabetic Retinopathy in South India

From the Aravind Medical Research Foundation, Aravind Eye Care System, Madurai, India

OBJECTIVE—To develop a screening protocol for detection of sight-threatening diabetic retinopathy in south India.

RESEARCH DESIGN AND METHODS—We performed ophthalmic examinations, including posterior segment examination, using indirect ophthalmoscopy to detect sight-threatening retinopathy in patients with diabetes in screening camps targeting a high-risk population.

RESULTS—We examined 3,949 persons with diabetes in 32 screening camps over a 13-month period beginning July 2001. Most of the patients (93.6%) were aware of their diabetic status, and 84.2% of those aware of their diabetes status were on treatment. One-fifth of those screened had evidence for any retinopathy; only 6.1% of these persons had evidence of past ophthalmic treatment for retinopathy. Only one-quarter of those diagnosed with worse than mild retinopathy came for follow-up to the base hospital within 2 months.

CONCLUSIONS—Screening high-risk groups for sight-threatening retinopathy using indirect ophthalmoscopy may be a useful short-term alternative for India until retinal photography becomes affordable. In addition to strategies to improve coverage, strategies for better follow-up of subjects screened also need to be evolved.

Abbreviations: CSME, clinically significant macular edema • NPDR, nonproliferative diabetic retinopathy • PDR, proliferative diabetic retinopathy

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