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Type: Journal article
Title: Diabetic retinopathy in a remote Indigenous primary healthcare population: a Central Australian diabetic retinopathy screening study in the Telehealth Eye and Associated Medical Services Network project
Author: Brazionis, L.
Jenkins, A.
Keech, A.
Ryan, C.
Brown, A.
Boffa, J.
Bursell, S.
CRE in Diabetic Retinopathy and the TEAMSnet Study Group
Citation: Diabetic medicine : a journal of the British Diabetic Association, 2018; 35(5):630-639
Publisher: Wiley
Issue Date: 2018
ISSN: 0742-3071
1464-5491
Statement of
Responsibility: 
L. Brazionis, A. Jenkins, A. Keech, C. Ryan, A. Brown, J. Boffa and S. Bursell, on behalf of the CRE in Diabetic Retinopathy and the TEAMSnet Study Group
Abstract: Aim: To determine diabetic retinopathy prevalence and severity among remote Indigenous Australians. Methods: A cross‐sectional diabetic retinopathy screening study of Indigenous adults with Type 2 diabetes was conducted by locally trained non‐ophthalmic retinal imagers in a remote Aboriginal community‐controlled primary healthcare clinic in Central Australia and certified non‐ophthalmic graders in a retinal grading centre in Melbourne, Australia. The main outcome measure was prevalence of any diabetic retinopathy and sight‐threatening diabetic retinopathy. Results: Among 301 participants (33% male), gradable image rates were 78.7% (n = 237) for diabetic retinopathy and 83.1% (n = 250) for diabetic macular oedema, and 77.7% (n = 234) were gradable for both diabetic retinopathy and diabetic macular oedema. For the gradable subset, the median (range) age was 48 (19–86) years and known diabetes duration 9.0 (0–24) years. The prevalence of diabetic retinopathy was 47% (n = 110) and for diabetic macular oedema it was 14.4% (n = 36). In the fully gradable imaging studies, sight‐threatening diabetic retinopathy prevalence was 16.2% (n = 38): 14.1% (n = 33) for clinically significant macular oedema, 1.3% (n = 3) for proliferative diabetic retinopathy and 0.9% (n = 2) for both. Sight‐threatening diabetic retinopathy had been treated in 78% of detected cases. Conclusions: A novel telemedicine diabetic retinopathy screening service detected a higher prevalence of ‘any’ diabetic retinopathy and sight‐threatening diabetic retinopathy in a remote primary care setting than reported in earlier surveys among Indigenous and non‐Indigenous populations. Whether the observed high prevalence of diabetic retinopathy was attributable to greater detection, increasing diabetic retinopathy prevalence, local factors, or a combination of these requires further investigation and, potentially, specific primary care guidelines for diabetic retinopathy management in remote Australia.
Keywords: CRE in Diabetic Retinopathy and the TEAMSnet Study Group; Humans; Diabetic Retinopathy; Diabetes Mellitus, Type 2; Diabetes Complications; Mass Screening; Severity of Illness Index; Prevalence; Multivariate Analysis; Logistic Models; Cross-Sectional Studies; Telemedicine; Adult; Aged; Aged, 80 and over; Middle Aged; Oceanic Ancestry Group; Primary Health Care; Australia; Female; Male; Macular Edema; Young Adult
Rights: © 2018 Diabetes UK.
RMID: 0030083322
DOI: 10.1111/dme.13596
Appears in Collections:Medicine publications

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