Common causes of blindness and visual handicap in the west of Scotland.

Ghafour, I M; Allan, Donald; Foulds, Wallace S.

doi:10.1136/bjo.67.4.209

Cited by 279 publications

(138 citation statements)

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“…In the west of Scotland DR was the fourth cause of blindness (8.5% of total) in 1980, and the most common cause in working age (20-64 years) [31]. In County Avon, in 1984 to 1986, DR came third (6.0%) and again the main cause among 30 to 69 year olds [32].…”

Section: Diabetes-related Blindnessmentioning

confidence: 99%

Diabetic retinopathy

2002

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Abstract. Easy observation of the fundus oculi makes retinopathy the most frequently reported chronic complication of diabetes and, consequently, the one we know best in terms of epidemiology and natural history. Achieving near-normal levels of blood glucose and blood pressure provides empirical though powerful tools for clinicians to delay the onset and progression of diabetic retinopathy. Even when these measures have failed and retinopathy becomes sight-threatening, laser photocoagulation has proven remarkably effective. Nonetheless, retinopathy remains a leading cause of blindness and there is little evidence that diabetes-related visual loss is decreasing in industrialized countries. This may result from the mixed blessing of prolonged survival of patients who had become diabetic when metabolic control was pursued less fastidiously than today. Screening for sight-threatening retinopathy is the most cost-effective medical procedure known and should help optimise the use of diagnostic and therapeutic resources, but its widest deployment still meets with inertia and lack of interest within most health care systems. Improving clinical skills and technology, however, allow us to take a more optimistic look at the future, as pathogenesis-targeted forms of treatment are being developed and tested through appropriately powered clinical trials. [Diabetologia (2002[Diabetologia ( ) 45:1617[Diabetologia ( -1634

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Section: Diabetes-related Blindnessmentioning

confidence: 99%

Diabetic retinopathy

2002

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“…In the United Kingdom Sorsby (1972) found that diabetic retinopathy was the single leading cause of new blindness in England and Wales in patients between ages 30 and 64, accounting for 15% of all new registered blindness. 10 years later Ghafour et al (1983) found that diabetic retinopathy was the most common cause of blindness in the age-group of 45-64 years in the west of Scotland, accounting for 10% of registered blindness, and at the same time Doesschate (1982) found diabetes to be the leading cause of blindness in the Netherlands, accounting for 21% of reported blindness. Sjølie and Green (1987) found the prevalence of blindness in a Danish population to be 5.9% in diabetics with a duration of more than 8 years and estimated the prevalence of blindness in diabetics to be 50-80 times higher than in the normal population.…”

Section: Visual Impairment In Diabeticsmentioning

confidence: 99%

Screening and prevention of diabetic blindness

Stefánsson

Bek

Porta

et al. 2000

Acta Ophthalmologica Scandinavica

254

180

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ABSTRACT. Diabetic eye disease remains a major cause of blindness in the world. Laser treatment for proliferative diabetic retinopathy and diabetic macular edema became available more than two decades ago. The outcome of treatment depends on the timing of laser treatment. The laser treatment is optimally delivered when high-risk characteristics have developed in proliferative retinopathy or diabetic macular edema and before this has significantly affected vision. Laser treatment is usually successful if applied during this optimal period whereas the treatment benefit falls sharply if the treatment is applied too late. In order to optimize the timing of laser treatment in diabetic eye disease screening programs have been established. The oldest screening program is 20 years old and several programs have been established during the last decade. In this paper the organisation and methods of screening programs are described including direct and photographic screening. The incidence and prevalence of blindness is much lower in populations where screening for diabetic eye disease has been established compared to diabetic populations without screening. Technical advantages may allow increased efficiency and telescreening. From a public health standpoint screening for diabetic eye disease is one of the most cost effective health procedures available. Diabetic eye disease can be prevented using existing technology and the cost involved is many times less than the cost of diabetic blindness.

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“…1,2 Diabetic retinopathy is seen in most type I diabetics and 60% of type II diabetics 20 years after diagnosis. 3 Approximately 2% of the UK population have diabetes, of whom 200 000 have type I (insulin dependent) and more than 1 million have type II (non-insulin dependent).…”

Section: Introductionmentioning

confidence: 99%

Is screening with digital imaging using one retinal view adequate?

Herbert

Jordan

Flanagan

2003

Eye

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Purpose To compare the detection of diabetic retinopathy from digital images with slit-lamp biomicroscopy, and to determine whether British Diabetic Association (BDA) screening criteria are attained (480% sensitivity, 495% specificity, o5% technical failure). Methods Diabetics referred for screening were studied in a prospective fashion. A single 451 fundus image was obtained using the nonmydriatic digital camera. Each patient subsequently underwent slit-lamp biomicroscopy and diabetic retinopathy grading by a consultant ophthalmologist. Diabetic retinopathy and maculopathy was graded according to the Early Treatment of Diabetic Retinopathy Study. Results A total of 145 patients (288 eyes) were identified for screening. Of these, 26% of eyes had diabetic retinopathy, and eight eyes (3%) had sight-threatening diabetic retinopathy requiring treatment. The sensitivity for detection of any diabetic retinopathy was 38% and the specificity 95%. There was a 4% technical failure rate. There were 42/288 false negatives and 10/288 false positives. Of the 42 false negatives, 18 represented diabetic maculopathy, 20 represented peripheral diabetic retinopathy and four eyes had both macular and peripheral changes. Three eyes in the false-negative group (1% of total eyes) had sight-threatening retinopathy. There was good concordance between the two consultants (79% agreement on slit-lamp biomicroscopy and 84% on digital image interpretation). Conclusion The specificity value and technical failure rate compare favourably with BDA guidelines. The low sensitivity for detection of any retinopathy reflects failure to detect minimal maculopathy and retinopathy outside the 451 image. This could be improved by an additional nasal image and careful evaluation of macular images with a low threshold for slit-lamp biomicroscopy if image quality is poor.

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Common causes of blindness and visual handicap in the west of Scotland.

Cited by 279 publications

References 0 publications

Diabetic retinopathy

Diabetic retinopathy

Screening and prevention of diabetic blindness

Is screening with digital imaging using one retinal view adequate?

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