Two-field non-mydriatic fundus photography for diabetic retinopathy screening: a protocol for a systematic review and meta-analysis

Prevalence Rates of Diabetic Retinopathy and Undiagnosed Diabetes Among Delaware Nursing Home and Assisted Living Facility Residents

Objectives: To determine the prevalence of diabetic retinopathy and undiagnosed diabetes among Delaware nursing home and assisted care facility residents. Methods: This cross-sectional study involved the statistical analysis of comprehensive eye examination records of 2,063 nursing home residents residing in 18 facilities and 4 assisted living facilities in Delaware from 2005 to 2009. Descriptive statistical analyses were conducted to identify the rates of retinal dot and blot hemorrhages and existing systemic diabetes diagnoses. Results: The mean age of nursing home and assisted care facility residents was 77 years (range 9-104), and 64.4% were over the age of 80. Most residents were female (61.1%) and white (72.5%). 3.6% of the 2,063 nursing home residents had blot or dot hemorrhages in one or both eyes. 32.8% had a type 1 or type 2 diabetes diagnosis. Of the ones with a positive dot and blot hemorrhage finding, 56.8% had a diagnosis of diabetes, and 43.2% did not. Discussion: There was a high prevalence of dot and blot hemorrhages without a systemic diagnosis of diabetes, indicating a need for regular eye care among residents.

[Retinal alterations detected by non-mydriatic retinal camera screening and referral to ophthalmology in a population with high cardiovascular risk]

OBJECTIVE

To describe the main retinal alterations detected by non-mydriatic retinal camera screening and to evaluate factors related to referral to ophthalmology in a population at high cardiovascular risk in Palmira, Colombia.

MATERIALS AND METHODS

Cross-sectional observational study, which included 11,983 photographic imaging records of patients with hypertension and diabetes mellitus from Gesencro's S.A.S. comprehensive chronic disease care program between 2018 and 2020. Risk factors associated to referral to ophthalmology were evaluated with logistic regression, and crude and adjusted ORs (odds ratios) were obtained.

RESULTS

A total of 11,880 records were analyzed; 67.7±12years old, and 69.5% were women. Among the retinal alterations were patients with diabetic retinopathy classified as more than mild in 10% and gradeI hypertensive retinopathy in 54.9% right eye, 51.9% left eye. Macular edema was also identified. Only 2069 patients (17.4%) required referral to ophthalmology, and for imaging control 82.6%. In the multivariate analysis, the risk factors associated with the probability of being referred were male gender, age 60years and older, glycosylated hemoglobin out-of-target, advanced chronic kidney disease and the microalbumin-to-creatinine ratio moderate to severely elevated.

CONCLUSION

This study makes it possible to determine the importance of screening with a non-mydriatic retinal camera in patients at high cardiovascular risk to detect retinal abnormalities and assess risk factors associated with referral to ophthalmology. Early documentation of ocular compromise in these patients could prevent and avoid visual impairment and blindness.

Value of Combining Optical Coherence Tomography with Fundus Photography in Screening Retinopathy in Patients with High Myopia

Objective

To explore the value of combining optical coherence tomography (OCT) with fundus photography in screening retinopathy in patients with high myopia.

Methods

By means of retrospective study, 40 high myopia patients with retinopathy treated in our hospital from January 2020 to January 2021 were selected as the study group, and 40 healthy individuals in the same period were included in the control group. All patients received traditional ophthalmic examination, and accepted fundus fluorescence imaging, OCT, and fundus photography examination step by step by the same operator. After that, three physicians read the slides by the double blind method, and took the results of fundus fluorescence imaging as the gold standard to analyze the diagnostic efficacy of OCT, fundus photography and their combination.

Results

The clinical data and examination results showed that no statistical differences in general data including patients' mean age, gender ratio, and educational degree between the study group and the control group were observed (P > 0.05), and the nerve thickness above/below the optic disk and temporal/nasal nerve thickness of the optic disk of the study group were significantly different from those of the control group (P < 0.001); the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy rate of diagnosis of combining OCT with fundus photography were respectively 95.0%, 97.5%, 97.4%, 95.1%, and 96.3%, which were significantly higher than OCT or fundus photography alone (P < 0.05); and for combined examination, AUC (95%CI) = 0.963 (0.000–1.000).

Conclusion

Combining OCT with fundus photography can effectively identify high myopia patients with retinopathy, which is conducive to improving clinical positive ratio and providing objective basis for treatment.