MACHO 21

Eye Department KCMC Newsletter

Issue 3 Volume 6 Serial 21                                                                     30 September 2016

OUTCOME OF DIABETIC RETINOPATHY SCREENING AT MT MERU HOSPITAL IN 2015

Introduction

As a prelude to developing a comprehensive diabetic program for Arusha Region, to replicate the successes of the Kilimanjaro Diabetic Program (2010 – 2014), the Eye Department KCMC commenced diabetic retinopathy screening at Mt Meru Regional Hospital in Arusha. This screening activity is conducted at the diabetic clinic, whereby all diabetic patients are offered to be screened for retinopathy. The fundus photographs are graded at KCMC and telephonic short text messaging feedback is given to the patients on whether they need to come to KCMC for further evaluation or treatment of they should be screened again in 12 months time.

Methodology

Eye Department KCMC Diabetic Retinopathy Screening Program, the successor of Kilimanjaro Diabetic Program provided registers to record all diabetic patients attending diabetic clinic at Mount Meru Regional Hospital in Arusha. Besides the registers, patients data cards and information booklets were also provided. The patient data cards offer a quick referencing method of the database. The patient information booklet provides health education to the patient and records important biological data. Each registered diabetic patient is given an appointment to come for fundus photography. Together with fundus photography, biological parameters such as age, weight, random glycemia and blood pressure are recorded. The photographs saved in a computer and ophthalmology resident grades them on whether they have No Diabetic Renopathy (R0), Background Diabetic Retinopathy (R1), Pre-proliferative Diabetic Renopathy (R2) and Proliferative Diabetic Retinopathy (R3). Maculopathy is graded on whether there is No Maculopathy (M0), Non-referable Maculopathy (MNR) or Clinically Significant Diabetic Macula Edema (M1).

Results

In 2015, some 164 patients were photographed between 22 May 2015 and 31 December 2015. There were some 43 men and 121 women. Some 27 patients out of 163 were referred to KCMC for further examination or treatment. Some five patients out of 164 were graded as proliferative diabetic retinopathy, forming some 3% of all the screened patients. Of these five patients, two were affected bilaterally. Some 28 patients had clinically significant diabetic macula edema, forming some 17% of the 164 patients. Thirteen of them (46% of the 28) had this condition in both eyes.

Discussion

In eight months of 2015, on average some 20.5 patients were screened every month. The prevalence of proliferation is similar to the 4300 patients of the Kilimanjaro Diabetic Program, at 3%. This is important for it puts the magnitude of the problem into perspective and allows for proper planning of ophthalmic medical services. The prevalence of clinically significant diabetic macula edema was 17% (Some 28 patients out of 164). Some 46% of the 28 patients with clinically significant diabetic macula edema were affected bilaterally. The absolute number of patients needing some kind of laser therapy is 30 (18.3%) representing 48 eyes. This scant information is going to be very useful in planning large scale population screening for diabetic retinopathy screening and estimating the resources needed.

Dismas Silonga the Medical Photographer taking a Fundus Photograph.

Editor: W. Makupa, Eye Department KCMC, P.O.Box 3010 Moshi – Tanzania

Tel: +255 784 332 667 or +255 27 275 4890 Email: makupauw@yahoo.com