Demographic features and visual outcomes of patients presenting to diabetic photo-screening and treated for sight threatening retinopathy in Fiji
A recent review of records from the Pacific Eye Institute Diabetic Eye Clinic in Suva, Fiji, describes alarming prevalence rates of diabetic retinopathy (DR) in patients presenting to photo-screening; higher than rates reported in other developed and developing settings. Globally, diabetic retinopathy is a significant and growing cause of blindness and visual impairment. In the Pacific Islands, it’s a particular concern due to high rates of diabetes and immature diabetic care pathways.
The research shows that over half of new patients presenting to photo-screening in 2010 had some degree of DR, a quarter have sight-threatening DR in at least one eye, and 10 percent have advanced sight-threatening DR in at least one eye. 133 of the 988 eyes with sight-threatening retinopathy had vision worse than 6/60 — clinically blind. These patients are unlikely to regain vision, even with surgical intervention.
Half of patients presenting with STR had elevated blood sugar levels, which suggests poor glycaemic control amongst the cohort. Male gender, history of hypertension, and neuropathy (a complication of diabetes) are all risk factors for STR.
Of the patients that underwent laser treatment, progression of the disease was halted at two years in 67 percent receiving macula laser, and 48 percent receiving PRP. Patients with good glycaemic control were able to maintain good vision at two years.
The findings of this study emphasise the importance of early referral, close follow-up and improved glycaemic control to reduce the likelihood of sight loss from diabetes.
The Fred Hollows Foundation NZ is committed to addressing these factors and looks forward to seeing progress in these indicators as the diabetes programme matures. Read more about how diabetes affects the eye and what we’re doing to tackle this problem in the Pacific here.
Bhikoo, R., Murray, N., Biu Sikivou, S. E., & McGhee, C. (2017).Demographic features and visual outcomes of patients presenting to diabetic photo-screening and treated for sight threatening retinopathy in Fiji. International Journal of Ophthalmology, 10(5), 790.