Early detection of diabetic retinopathy by a mobile retinal photography service working in partnership with primary health care teams

Diabet Med. 1998 Nov:15 Suppl 3:S32-7. doi: 10.1002/(sici)1096-9136(1998110)15:3+<s32::aid-dia728>3.3.co;2-4.

Abstract

Community-wide fundus photography was organized for early detection of diabetic retinopathy (DR) by mobile teams. High-quality three-field Kodachrome fundus photography, performed according to the London Protocol through dilated pupils was offered free of charge to primary care; images were taken in the community and assessed centrally. Data are presented from the first 80 primary health care centres (PHCCs) participating, serving 990,000 (about 60%) of inhabitants in Stockholm County. Beginning in 1990, 6863 diabetes patients were invited by PHCCs; 5490 (80%) attended. We reached 77% of persons with known diabetes; only 37% had had their eyes examined during the preceding 2 years. For 97% of patients, images were assessable. DR was present in 34% of patients (non-proliferative DR not requiring further assessment 29%, non-proliferative DR requiring further assessment 1.1%, proliferative DR 0.5% and macular involvement 3.6%). Re-examination after 2 years was offered to 64%; follow-up photography after 1 year to 24%. Fluorescein angiography and/or photocoagulation treatment was performed in 3.6%. This method of early diagnosis is feasible, acceptable, and reached twice as many patients as did the usual referral-based system of care. We now plan to extend this service to cover the whole county.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Diabetes Mellitus, Type 2*
  • Diabetic Retinopathy / diagnosis*
  • Diabetic Retinopathy / therapy
  • Humans
  • Middle Aged
  • Mobile Health Units*
  • Photography*
  • Primary Health Care