SCREENING FOR DIABETIC-RETINOPATHY USING A NONMYDRIATIC RETINAL CAMERA IN RURAL VICTORIA

Purpose: To develop a screening programme for the early detection of d iabetic retinopathy using non-mydriatic retinal photography Methods: A community based screening service was offered to all people with know n diabetes mellitus in selected townships in the LaTrobe and Goulburn Valleys in Victoria. At the local examination centre, basic sociodemog raphic information was collected as well as details of previous use of eye care services for the early detection of diabetic retinopathy. Th e examination included visual acuity (VA), glycosylated haemoglobin le vel and Polaroid photographs of each fundus using a Canon CR5-45NM non -mydriatic retinal camera (Canon, Tochigiken, Japan). Dilating drops w ere not used. Photographs were subsequently reviewed and letters were sent to all participants (with copies to their general practitioners) with recommendations for appropriate follow up. Results: A total of 11 77 people with diabetes attended the screening service, which is estim ated to be 40% of the total population with known diabetes in the stud y area. The mean age was 65 years (range 20-94 years): 559 (48%) peopl e reported not having a dilated fundus examination within the past 2 y ears; 345 (29%) people had never had a dilated fundus examination. Of the 2354 eyes, 2126 (90%) of the photographs were gradable. A total of 704 people (60%) had normal VA and no evidence of diabetic retinopath y, 209 people (18%) had diabetic retinopathy, 101 people (9%) had evid ence of other fundus pathology, 42 people (3%) had reduced acuity (<6/ 18) in one or both eyes (with no fundus pathology evident) and 121 peo ple (10%) had ungradable photographs in one or both eyes. Conclusions: The present study demonstrates the usefulness of a screening programm e with non-mydriatic retinal photography as an adjunct to current eye care services ibr the early detection of diabetic retinopathy.