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  • Title: The prevalence of diabetic retinopathy in Trang province determined by retinal photography and comprehensive eye examination.
    Author: Supapluksakul S, Ruamviboonsuk P, Chaowakul W.
    Journal: J Med Assoc Thai; 2008 May; 91(5):716-22. PubMed ID: 18672638.
    Abstract:
    OBJECTIVE: To determine the prevalence of diabetic retinopathy (DR) in Trang province using retinal photography and comprehensive eye examination. METHOD: Seven hundred fourteen patients with diabetes (7% of the total number of diabetes in the province) were examined by single-field digital retinal photography interpreted by a retinal specialist and a stereoscopic method using indirect ophthalmolscopy and slit lamp biomicroscopy with wide field contact lens. The latter method was performed by an experienced ophthalmologist assisted by the same retinal specialist. RESULTS: There was 19.2% nonproliferative diabetic retinopathy (NPDR), and 1.1% proliferative diabetic retinopathy (PDR), identified by the comprehensive examination for the right eyes. This modality also identified 18.5% NPDR, and 1.3% PDR, for the left eyes. There was 23.8% nonproliferative diabetic retinopathy (NPDR), and 1.4% proliferative diabetic retinopathy (PDR) identified by retinal photography for the right eyes. This modality also identified 22.6% NPDR, and 1.3% PDR for the left eyes. The sight-threatening cases were identified by both modalities with approximately 3% for both eyes. The photography had moderate agreement (K = 0.5, both eyes) with the comprehensive examination for the identification of diabetic macular edema with 78.6% and 68.8% sensitivity for the right and left eyes. For the identification of moderate NPDR, severe NPDR, and PDR, the photography had substantial agreement (K = 0.7, both eyes) with 88.2% and 83.3 sensitivity for the right and left eyes. CONCLUSIONS: Trang province may have approximately 300 sight-threatening DR patients. This may project to 180,000 patients nationwide. Retinal photography may determine more cases than clinical examination. Combination of both modalities for DR identification may yield a closer estimate to the real prevalence.
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