TY - JOUR
T1 - Addressing risk factors, screening, and preventative treatment for diabetic retinopathy in developing countries
T2 - a review
AU - Lin, Stephanie
AU - Ramulu, Pradeep
AU - Lamoureux, Ecosse L.
AU - Sabanayagam, Charumathi
N1 - Publisher Copyright:
© 2016 Royal Australian and New Zealand College of Ophthalmologists
PY - 2016/5/1
Y1 - 2016/5/1
N2 - The number of people with diabetic retinopathy (DR) has increased with the increasing prevalence of diabetes mellitus worldwide, especially in developing countries. In recent years, the successful implementation of public health programs in developed countries has been thought to contribute to decreases in blindness from DR. Developing countries, however, have not seen the same improvements, and their public health interventions still face significant challenges. In this review we describe the current state of public health approaches including risk factor control, screening and treatment techniques for DR in developing countries, and suggest recommendations. While the awareness of DR is variable, specific knowledge about DR is low, such that many patients have already experienced vision loss by the time they are screened. Attempts to improve rates of screening, in particular through non-mydriatic cameras and tele-screening, are ongoing and promising, although challenges include collaboration with healthcare systems and technology failures. Laser treatment is the most readily available, with anti-VEGF therapy and vitreo-retinal surgery increasingly sought after and provided. Recommendations include the use of ‘targeted mydriasis’ for fundus imaging to address high rates of ungradable images, increased communication with diabetes management services to improve patient retention and mobilization of access to DR treatments.
AB - The number of people with diabetic retinopathy (DR) has increased with the increasing prevalence of diabetes mellitus worldwide, especially in developing countries. In recent years, the successful implementation of public health programs in developed countries has been thought to contribute to decreases in blindness from DR. Developing countries, however, have not seen the same improvements, and their public health interventions still face significant challenges. In this review we describe the current state of public health approaches including risk factor control, screening and treatment techniques for DR in developing countries, and suggest recommendations. While the awareness of DR is variable, specific knowledge about DR is low, such that many patients have already experienced vision loss by the time they are screened. Attempts to improve rates of screening, in particular through non-mydriatic cameras and tele-screening, are ongoing and promising, although challenges include collaboration with healthcare systems and technology failures. Laser treatment is the most readily available, with anti-VEGF therapy and vitreo-retinal surgery increasingly sought after and provided. Recommendations include the use of ‘targeted mydriasis’ for fundus imaging to address high rates of ungradable images, increased communication with diabetes management services to improve patient retention and mobilization of access to DR treatments.
KW - Awareness
KW - developing countries
KW - diabetic retinopathy
KW - prevention
KW - screening
KW - treatment
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U2 - 10.1111/ceo.12745
DO - 10.1111/ceo.12745
M3 - Review article
C2 - 26991970
AN - SCOPUS:84974824317
SN - 1442-6404
VL - 44
SP - 300
EP - 320
JO - Clinical and Experimental Ophthalmology
JF - Clinical and Experimental Ophthalmology
IS - 4
ER -