Endocrine Abstracts

Background: The increasing prevalence of diabetes mellitus (DM) is leading to a higher number of patients with diabetic retinopathy (DR) being referred to an ophthalmologist. In order to provide better care for patients, the Department of Endocrinology at the University Hospital of Zagreb has started screening of the ocular fundus.

Objectives: The aim was to present the results of screening on DR in a random sample of DM patients and to compare the results analysed by an endocrinologist and an ophthalmologist during the first three months of the project.

Methods: The variables analysed were age, sex, type and duration of DM, insulin therapy, HbA1c, body mass index, renal function, and blood pressure. The Crystalvue non-mydriatic fundus camera was used for ocular fundus analysis. The endocrinologist analysed the photographs first, and then the ophthalmologist analysed via telemedicine.

Results: The total number of patients who underwent screening for DR was 194 (median age 50 years (19-85), 102 were male, 48 had type 1 DM, 132 type 2 DM, and 14 corticosteroid-induced DM. Twenty-six had DR. When comparing outcomes assessed by endocrinologists and ophthalmologists, a total of 21 patients (11 %) had differences in outcomes. Sixteen patients were classified by endocrinologists as false-positive for DR, whereas 5 patients were classified as false-negative for DR. The number of false-positive or false-negative results between months was not statistically significant, but the tendency for results to differ between endocrinologist and ophthalmologist was less from month to month (9 vs. 8 vs. 4).

Conclusion: The results indicate that screening for DR can be performed by an endocrinologist with the assistance of an ophthalmologist at baseline. With a non-mydriatic fundus camera in the endocrinology department, we could reduce the workload of ophthalmologists and assign them only patients with DR to provide faster and better care for DM patients.