Demographic features and visual outcomes of patients presenting to diabetic photo-screening and treated for sight threatening retinopathy in Fiji

AIM: To describe the demographic features and visual outcomes of patients presenting to photo-screening services, and treated for sight threatening retinopathy (STR) in a low resource setting, Fiji. METHODS: A retrospective review of all new patients who presented for diabetic photo-screening at th...

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Main Authors: Riyaz Bhikoo, Neil Murray, Biu Sikivou, Stephanie Emma, Charles McGhee
Format: Article
Language:English
Published: Press of International Journal of Ophthalmology (IJO PRESS) 2017-05-01
Series:International Journal of Ophthalmology
Subjects:
Online Access:http://www.ijo.cn/en_publish/2017/5/20170522.pdf
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author Riyaz Bhikoo
Neil Murray
Biu Sikivou
Stephanie Emma
Charles McGhee
author_facet Riyaz Bhikoo
Neil Murray
Biu Sikivou
Stephanie Emma
Charles McGhee
author_sort Riyaz Bhikoo
collection DOAJ
description AIM: To describe the demographic features and visual outcomes of patients presenting to photo-screening services, and treated for sight threatening retinopathy (STR) in a low resource setting, Fiji. METHODS: A retrospective review of all new patients who presented for diabetic photo-screening at the Diabetic Eye Clinic, Suva in 2010. Fundus images were graded using standardised guidelines. Patient demographics, retinopathy grading and visual acuity data were extracted from the database and analyzed. Patients that received laser therapy and still attending follow up in 2012 were examined for disease progression RESULTS: Totally 2236 patients were photo-screened, 87% (3870/4472) of images were gradable. STR was observed in 26% (988/3870) with advanced STR (proliferative retinopathy/severe maculopathy) in 10% (385/3870). Of those with STR, 59% had BCVA ≥6/18, 31% with advanced STR were <6/60. Male gender [odds ratio (OR) 1.59; 1.20-2.12], history of hypertension (OR 1.36; 1.03-1.80) and peripheral neuropathy (OR 1.41; 1.01-1.95) were predictive of advanced STR. In 2012, 32% (315/988) attended follow up with 69% exhibiting advanced STR compared with 53% of the same cohort in 2010. Laser photocoagulation was administered to 212 eyes (212/3870, 5%) with retinopathy and maculopathy progression observed in 52% and 33% respectively. BCVA ≥6/18 was noted in 67% (143/212) of treated eyes. Improved glycaemic control (OR 46.52; 1.50-1441.90) amongst those with advanced STR was predictive of eyes that maintained good vision. CONCLUSION: In Fiji, a quarter of new patients presenting to photo-screening have STR with a third of those with advanced STR having already loss vision. Improved glycaemic control and timely treatment of patients with sight threatening complications is important in halting disease progression.
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spelling doaj.art-bd1a71dab10a452abdad47dcedbe17d12022-12-21T21:10:13ZengPress of International Journal of Ophthalmology (IJO PRESS)International Journal of Ophthalmology2222-39592227-48982017-05-0110579079510.18240/ijo.2017.05.22Demographic features and visual outcomes of patients presenting to diabetic photo-screening and treated for sight threatening retinopathy in FijiRiyaz Bhikoo0Neil Murray1Biu Sikivou2Stephanie Emma3Charles McGhee4The Fred Hollows Foundation New Zealand, Auckland 1023, New Zealand; Department of Ophthalmology, New Zealand National Eye Centre, University of Auckland, Auckland 1023, New ZealandThe Fred Hollows Foundation New Zealand, Auckland 1023, New ZealandThe Fred Hollows Foundation New Zealand, Auckland 1023, New Zealand; Pacific Eye Institute, Suva, FijiThe Fred Hollows Foundation New Zealand, Auckland 1023, New ZealandDepartment of Ophthalmology, New Zealand National Eye Centre, University of Auckland, Auckland 1023, New ZealandAIM: To describe the demographic features and visual outcomes of patients presenting to photo-screening services, and treated for sight threatening retinopathy (STR) in a low resource setting, Fiji. METHODS: A retrospective review of all new patients who presented for diabetic photo-screening at the Diabetic Eye Clinic, Suva in 2010. Fundus images were graded using standardised guidelines. Patient demographics, retinopathy grading and visual acuity data were extracted from the database and analyzed. Patients that received laser therapy and still attending follow up in 2012 were examined for disease progression RESULTS: Totally 2236 patients were photo-screened, 87% (3870/4472) of images were gradable. STR was observed in 26% (988/3870) with advanced STR (proliferative retinopathy/severe maculopathy) in 10% (385/3870). Of those with STR, 59% had BCVA ≥6/18, 31% with advanced STR were <6/60. Male gender [odds ratio (OR) 1.59; 1.20-2.12], history of hypertension (OR 1.36; 1.03-1.80) and peripheral neuropathy (OR 1.41; 1.01-1.95) were predictive of advanced STR. In 2012, 32% (315/988) attended follow up with 69% exhibiting advanced STR compared with 53% of the same cohort in 2010. Laser photocoagulation was administered to 212 eyes (212/3870, 5%) with retinopathy and maculopathy progression observed in 52% and 33% respectively. BCVA ≥6/18 was noted in 67% (143/212) of treated eyes. Improved glycaemic control (OR 46.52; 1.50-1441.90) amongst those with advanced STR was predictive of eyes that maintained good vision. CONCLUSION: In Fiji, a quarter of new patients presenting to photo-screening have STR with a third of those with advanced STR having already loss vision. Improved glycaemic control and timely treatment of patients with sight threatening complications is important in halting disease progression.http://www.ijo.cn/en_publish/2017/5/20170522.pdf795diabetic retinopathysight threateningphotocoagulationpacific islandsdeveloping countries
spellingShingle Riyaz Bhikoo
Neil Murray
Biu Sikivou
Stephanie Emma
Charles McGhee
Demographic features and visual outcomes of patients presenting to diabetic photo-screening and treated for sight threatening retinopathy in Fiji
International Journal of Ophthalmology
795
diabetic retinopathy
sight threatening
photocoagulation
pacific islands
developing countries
title Demographic features and visual outcomes of patients presenting to diabetic photo-screening and treated for sight threatening retinopathy in Fiji
title_full Demographic features and visual outcomes of patients presenting to diabetic photo-screening and treated for sight threatening retinopathy in Fiji
title_fullStr Demographic features and visual outcomes of patients presenting to diabetic photo-screening and treated for sight threatening retinopathy in Fiji
title_full_unstemmed Demographic features and visual outcomes of patients presenting to diabetic photo-screening and treated for sight threatening retinopathy in Fiji
title_short Demographic features and visual outcomes of patients presenting to diabetic photo-screening and treated for sight threatening retinopathy in Fiji
title_sort demographic features and visual outcomes of patients presenting to diabetic photo screening and treated for sight threatening retinopathy in fiji
topic 795
diabetic retinopathy
sight threatening
photocoagulation
pacific islands
developing countries
url http://www.ijo.cn/en_publish/2017/5/20170522.pdf
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