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

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.