36
The
th Annual Meeting of March 21-22, 2015 The Endocrine Society and The Diabetes Association of the R.O.C. (Taiwan)
SD-5-1
Epidemiology, Classification and Screening of Diabetic Retinopathy Shih-Jen Chen Department of Ophthalmology, Taipei Veterans General Hospital School of Medicine, National Yang-Ming University, Taiwan, R.O.C.
Objective: To review and update the epidemiology, classification and screeing of diabetic retinopathy (DR) and diabetic macular edema (DME). Materials And Methods: Literatures review including epidemiological studies and the national health institute databank studies in Taiwan as well as recent studies of treatment of DME. Results: Because of population growth and increase aging, prevalence of glycaemia and diabetes are rising globally. The global prevalence of any DR is 35% and 10% for vision threatening DR. The prevalence varied across different ethnic groups. Risk factors for DR included diabetes duration, HbA1c, blood pressure and type 1 DM. Classification of DR is important in order to establish adequate therapy. The International Clinical Disease Severity Scale was widely accepted for the classification of DR because it is simple to use, easy to remember, and based on scientific trials. It is a clinical examination and does not require special tests such as fluorescein angiography or optical coherent tomography (OCT). Fundus pictures, if available, are used to document, evaluate and follow the severity of DR. For screening purpose, single-field photographs centered at the macula are sufficient to identify patients with retinopathy for referral. Increase the photographic fields to 3 will be effective in determining the critical level of retinopathy for prompt referral. However, the hurdle for prevention of blindness in diabetic patients lies on screening and early detection of DR since 90% of the cases can be prevented from visual loss by proper management. The retina screening rate in patients with diabetes in Taiwan, the ways developed to improve the screening rate and decrease the time for diagnosis will be discussed in this talk. Conclusions: Visual loss from DR is largely preventable with proper screening based upon timely application of photocoagulation or intravitreal injection of anti-vascular endothelial growth factors. Fundus photography and standardized classification of DR allowed for communication and discussion between the endocrinologists and ophthalmologists. Recent technology of digital nonmydriatic fundus camera, automatic image detection of retinal pathology and telemedicine may facilitate the screening of DR.
126
