Diabetic retinopathy – the Ophthalmology Society of Southern Africa screening programme

Cook, Stephen

doi:10.7196/samj.7136

Cited by 11 publications

(14 citation statements)

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“…Digital fundus photography screening is established in many developed countries, and Khan et al [2] have suggested that this is cost-effective in SA. We are pleased to note the recent efforts of Cook and others to highlight and promote screening in SA, [5,6] including quality assurance assessment of the graders of fundus photographs. [7] Unfortunately there are currently virtually no established screening programmes, and patients' systemic control is often poor.…”

Section: Discussionmentioning

confidence: 99%

Outcomes of vitrectomy for advanced diabetic retinopathy at Groote Schuur Hospital, Cape Town, South Africa

Rice

Steffen

2015

S Afr Med J

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Diabetic blindness is a preventable condition. Unfortunately diabetic screening and early intervention are not yet available for most of the diabetic population in the state sector in South Africa (SA). A recent review of 248 diabetic patients attending a day hospital in Cape Town revealed that only 5.2% had regular annual fundus examinations and only 10.4% were aware that annual fundoscopy was required. [1] Although screening programmes have been piloted or partially implemented in a few localised centres, [2,3] the severe deficiencies in current screening and laser management mean that large numbers of patients present with advanced ocular complications of diabetes. Management of these patients usually requires surgical intervention (vitrectomy), and visual outcomes remain unpredictable. Fifty per cent of vitrectomies performed at Groote Schuur Hospital (GSH), Cape Town, are for the complications of diabetic retinopathy, and we anticipate that the proportion may be similar at other state hospitals. In resource-limited settings it is appropriate to examine the outcomes of retinal surgery and to assess context-specific risk factors that may influence surgical outcomes, as well as decisions affecting resource allocation. We are not aware of any publications of this type from SA state facilities. Methods We performed a retrospective cohort study of consecutive patients undergoing diabetic vitrectomy at GSH from January 2012 to December 2012 with up to 6 months' follow-up. All patients were assessed and listed for surgery by four vitreoretinal consultants (one full-time and three sessional consultants) and one trainee vitreoretinal consultant in the department. Preoperative visual acuities were recorded using Snellen charts. The time from listing for surgery to the date of the operation was recorded, as well as any change in visual acuity during this period. Surgical cancellations or postponements were recorded. Routine preoperative tests included an assay for urea and electrolytes. Intraoperative details were recorded by each surgeon. Early (within 1 month) and late postoperative complications were noted. If silicone oil was inserted during the procedure, time until removal of oil was recorded. Postoperative visual acuity was assessed at 3 and 6 months, and cases were considered anatomical successes if the retina was completely attached with no features of proliferation in the absence of a tamponading agent (e.g. silicone oil). All data were collected in Epidata and transferred to STATA 12 (Stata Statistical Software: Release 12, StataCorp, USA) for analysis. Visual acuity was converted to the logarithm of the minimum angle of resolution (LogMAR) for statistical analysis. The χ 2 test or Fisher's exact test was used for categorical variables and Student's t-test and the rank sum test for continuous variables. Logistic regression was used to examine prognostic factors. The study was approved by the University of Cape Town Human Research Ethics Committee (approval number: HREC 851/2014). Results During the study peri...

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Section: Discussionmentioning

confidence: 99%

Outcomes of vitrectomy for advanced diabetic retinopathy at Groote Schuur Hospital, Cape Town, South Africa

Rice

Steffen

2015

S Afr Med J

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“…The most-often used method is two-field pictures of the retina: performed in the UK, USA, Israel and Ireland. 11,12,[16][17][18]25,44,51 Similarly, only one picture of the retina is used in Scotland, 21 Spain, 36 South Africa 41 and Singapore. 48 A special type of onefield retinal picture in the German project is the use of one, ultrawide picture taken by Optomap, 45,46 which is a interesting alternative for two-field photography.…”

Section: Discussionmentioning

confidence: 99%

Review of Diabetic Retinopathy Screening Methods and Programmes Adopted in Different Parts of the World

Pieczyński¹,

Grzybowski²

2015

European Ophthalmic Review

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Introduction:One of most common diabetic complications is diabetic retinopathy (DR). Sight-threatening DR can be avoided when diagnosed early and treated in a timely fashion. The aim of this study is to review current worldwide DR screening programmes and studies.Methods:A PubMed platform search was performed to find clinical trials or studies of current DR screening methods.Results:Direct and indirect ophthalmoscopy is still used, but digital photography of the retina seems to be the most efficient, objective and cost-effective.Conclusions:DR screening programmes are developed all over the world. They help to detect early sight-threatening DR, treat it in a timely fashion and in this fashion help to avoid expensive, advanced treatment or even prevent to develop blindness among working age people.

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“…A Forum article informs us of a practical and pragmatic screening programme for DR developed by the Ophthalmological Society of Southern Africa, aimed at catching patients at primary care level and referring them for specialist treatment before sight is lost. [7]…”

Section: Diabetes Care In South Africatwo Ends Of the Spectrummentioning

confidence: 99%

Editor's Choice

Seggie¹

2013

S Afr Med J

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Diabetic retinopathy – the Ophthalmology Society of Southern Africa screening programme

Cited by 11 publications

References 1 publication

Outcomes of vitrectomy for advanced diabetic retinopathy at Groote Schuur Hospital, Cape Town, South Africa

Outcomes of vitrectomy for advanced diabetic retinopathy at Groote Schuur Hospital, Cape Town, South Africa

Review of Diabetic Retinopathy Screening Methods and Programmes Adopted in Different Parts of the World

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