Prospective comparison of two methods of screening for diabetic retinopathy by nonmydriatic fundus camera

Pedro Romero-Aroca¹, Ramon Sagarra-Alamo², Josep Basora-Gallisa², Teresa Basora-Gallisa², Marc Baget-Bernaldiz², Angel Bautista-Perez^1
1Ophthalmology Service, Hospital Universitario Sant Joan, IISPV, Universidad Rovira I Virgili, ²Health Primary Care Region Reus-Priorat, Universidad Rovira I Virgili, Reus, Spain

Purpose: To compare the results obtained by two screening techniques for diabetic retinopathy.
Methods: Patients were assessed in two groups, according to whether the retinal images were analyzed by the general practitioner (Group 1) or by the ophthalmologist (Group 2) in a two-year prospective study using telemedicine.
Results: The number of patients referred to the nonmydriatic fundus camera unit was higher in Group 1 than in Group 2 (63.80% versus 17.63%). Greater patient adherence was observed in Group 1 than in Group 2 when patients came to retinography (98.25% versus 87.52%). There were no significant differences in other technique variables. The prevalence of diabetic retinopathy was similar in both groups (8.98% in Group 1 and 9.16% in Group 2), but the prevalence of severe proliferative diabetic retinopathy was higher in Group 2 (1.69% [severe] and 0.45% [proliferative]) than in Group 1 (1.01% and 0.11%, respectively). Diabetic macular edema was more prevalent in Group 2 (2.03%).
Conclusions: The inclusion of general practitioners in the screening method seems to be important. A great number of patients with diabetes mellitus were screened, and a higher percentage of patients with diabetic retinopathy or macular edema were detected.

Keywords: nonmydriatic fundus camera, diabetic retinopathy, diabetes mellitus, diabetic macular edema, diabetic retinopathy, epidemiology