DIABETIC EYE SCREENING IN SIR GANGA RAM HOSPITAL, LAHORE.

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Abstract

Background: Diabetic retinopathy is the optical complication that may lead
to impaired vision. It is one of the most prevalent but preventable blinding disease. Its early
diagnosis is prerequisite for the prevention of the visual loss and blindness associated with
diabetic complication. Objective: To estimate frequency of eye examination and various types
of retinopathy; and to find the association between diabetic retinopathy and its risk factors.
Methods: The cross sectional study was conducted from Apr-Sep 2012 by PMRC Research
Centre, FJMC, Lahore. Using non probability convenient sampling, eighty known type II
diabetics were recruited. Venous blood was drawn for plasma glucose level (GOD-PAP) and
glycosylated hemoglobin (Ion-Exchange Resin). Arterial blood pressure was measured using
digital apparatus (Oscillometric method). Visual acuity was tested by Snellen’s chart and dilated
fundus examination was done to screen diabetic retinopathy. Data was analyzed using Statistical
Package for Social Sciences (SPSS-20). Results: The study included 41% males and 59%
females. Mean age was 51±9 (33-67) years. Diabetics who never screened for retinopathy were
54.3%; and who examined during last year as per IDF guidelines were 25.7%. The frequency
of bilateral and unilateral NPDR was 22.5% and 5%, respectively. The occurrence of NPDR was
slightly higher in left eye, whereas PDR was more prevalent in right eye. The visual acuity was
equal or better than 6/12 in better eye of 80% study participants; and was 6/18-6/36 in better eye
of 20% participants. DR was significantly associated with longer duration of diabetes (p-0.010),
poorly controlled diabetes (p-0.044) and hypertension (p-0.006). Odd ratios (95% CI) showed
that duration of diabetes ≥20 years, glycosylated hemoglobin ≥7.5 %, Systolic blood pressure ≥140 mm/
Hg and diastolic blood pressure ≥90 mm/Hg had 3-5 times higher risk of retinopathy. Conclusion:
Majority of patients were neither knew nor referred for eye examination. Strict control of diabetes
and hypertension may prevent or delay diabetic retinopathy. Policy Message: Annual eye
examination must be prescribed by the physician/ diabetologist. An education and awareness
program for diabetics and community based survey is highly recommended.