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“Prevention of Blindness”. Is diabetic retinopathy a preventable disease? By Amr ElKamshoushy , MD. Diabetic retinopathy is the leading cause of blindness in industrialized world. Diabetic retinopathy after 20 years of DM: Type 1  99% Type 2  60% (WESDR).

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Presentation Transcript
slide6
Diabetic retinopathy after 20 years of DM:

Type 1  99%

Type 2  60%

(WESDR)

slide7
After 20 years of DM:

Younger onset patients (<30 yrs at diagnosis)  3.6%Legally blind

Older onset patients (≥30 yrs at diagnosis)  1.6%Legally blind

(WESDR)

slide8
Legal blindness attributable to DR:

Younger-onset group  86%

Older-onset group  33%

(WESDR)

slide11
With early detection and timely applied laser treatment we can intervene in the natural course of diabetic retinopathy and prevent 95-98% of the vision loss due to diabetes.
slide15
“It is mandatory to have a fundus examination of every diabetic patient taken every year with proper referral”
slide17
Screening examination in the office of the GP or the diabetologist where the patient already goes regularly.
timing of first dilated ophthalmologic examination
Timing of first dilated ophthalmologic examination:

Following AAO preferred practice pattern

recommended follow up schedule
Recommended follow up schedule:

Following AAO preferred practice pattern

method of examination
Method of examination:
  • A fully dilated examination

* Sensitivity decreases by 50% if the eyes are undilated.

  • Photography through dilated or (undilated) pupils

* Easy – Acceptable – Mobile teams

* Offers twice the utilization as a usual referral based system of care.

slide22
“Prevention of diabetic retinopathy is attainable once the diagnosis of diabetes mellitus is made and intensive treatment instituted”
diabetes control and complication trial dcct
Diabetes Control and Complication Trial (DCCT)

In 9 years, a 76% reduction of diabetic retinopathy progression was found in intensive group compared with the conventional treatment group.

united kingdom prospective diabetes study ukdps
United Kingdom Prospective Diabetes Study (UKDPS)

After 7.5 years, the group with tight control of hypertension (<105/85 mmHg) showed a 34% reduction in the risk of progression of retinopathy compared to the less tight control group (<180/105 mmHg).

slide30
Yes it is possible to greatly reduce the incidence of blindness from diabetic retinopathy through:
  • Early detection of DR
  • A tighter control of diabetes
  • A tight control of associated hypertension
  • Patient education and compliance