Background:  With the increase in the prevalence of diabetes, rural optometric clinics stand to increase their patient load and assessment of diabetic eye disease. This study aimed to assess whether automated identification of diabetic retinopathy based on the presence of microaneurysms is an effective tool in clinical practice. Methods:  We analysed 758 fundal images of 385 patients with diabetes attending the clinic obtained using a Canon CR5 with an EOS10 digital camera through a dilated pupil. Five optometrists employed in the clinic assessed the diabetic retinopathy using binocular indirect ophthalmoscopy. The sensitivity and specificity of the automated system used to analyse the retinal fundal images was determined by comparison with optometric and ophthalmologic assessment. Results:  The optometrists achieved 97 per cent sensitivity at 88 per cent specificity with respect to the ophthalmic classification for detecting retinopathy. The automated retinopathy detector achieved 85 per cent sensitivity at 90 per cent specificity at detecting retinopathy. Conclusion:  The automated microaneurysm detector has a lower sensitivity compared to the optometrists but meets NHMRC guidelines. It may impact on the efficiency of rural optometric practices by early identification of diabetic retinopathy. Automated assessment can save time and be cost‐effective, and provide a history of changes in the retinal fundus and the opportunity for instant patient education using the digital images.

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Treatment of newborn rats with antiserum to nerve growth factor (NGF) for the first 6 postnatal days produced a loss of the sympathetic neurones that normally project to the sweat glands of the hind paws of the rat, indicating that cholinergic sympathetic neurones require NGF postnatally for their survival. Following this immunosympathectomy, there was an increase in the proportion of glands containing sensory fibres having substance-P-like immunoreactivity (SP-LI). This sensory sprouting was not as extensive as that after sympathectomy using 6-hydroxydopamine (6-OHDA). During normal development, fibres showing SP-LI are associated with the glands, particularly during the first and second postnatal weeks. Prolongation of the antibody treatment until the third postnatal week reduced the sensory fibre ingrowth from the region of the glands, suggesting that the basis of this growth is the increased availability of NGF following sympathetic denervation. Retrograde cell labelling using the fluorescent dye, fast blue, indicated that the anti-NGF treatment did not significantly decrease the number of sensory neurones projecting to an individual foot pad. These results support the hypothesis that sympathetic and sensory neurones compete for NGF produced by target tissues.

High blood pressure leads to greater risk of cardiovascular disease morbidity and mortality. Our aim was to determine the prevalence of hypertension in a cohort of people attending a rural university health screening program in response to community advertisements. In all, 674 individuals attended the screening program at our university health clinic in Albury. The presence and treatment of diagnosed hypertension were reported by 37.3% of participants. Antihypertensive medications were used in 42.9% of the known hypertensives, and fewer than half of these patients on antihypertensive agents achieved a normal blood pressure. New hypertension in accordance with the AusDiab criteria that is not diagnosed and treated was identified in 20.8% of participants. We conclude that the rates of antihypertensive treatment were low in this rural population, and that in those who were treated, a large portion still remained hypertensive. The management and monitoring of hypertension in this rural community needs to be improved to capture the additional people with hypertension and to reduce blood pressure to recommended levels.