Diabetic retinopathy in Priest Hospital

Background: Diabetic retinopathy (DR) is common complication of DM and is one of the leading causes of visual loss in working age population in developed and developing countries. The known risk of retinopathy is directly related to the degree and duration of hyperglycemia. Priests are one of the disadvantageous groups because they cannot select their food and have poor access to health care. These two reasons are suspected to be causes of high prevalence of DM and DR in the priests.

Objectives: To perform complete eye examinations and take fundus pictures at DR screening to estimate the prevalence of DR in the priests and to perform appropriate treatment.

Material and methods: Retrospective review of the medical records of the priests and novices who had diabetes in Priest Hospital between October 2005 and September 2007 was done. Appointment for crosssectional DR screening for those who never had an eye exam and to complete DR treatment.

Results: Four hundred and fourteen diabetic priests and novices were enrolled in the study with the mean age was 61.65 years. Only 297 (71.74 %) of the diabetic priests had a visual acuity measurement previously. DR screening program was done in 176 priests. The result revealed that 123 priests had no DR (69.89 %), 33 (18.75%) had non-proliferative DR (NPDR), 20 (11.36%) had proliferative DR (PDR), and 11 (6.25% or 33.33% of NPDR) had clinically significant macula edema (CSME). From the previously diagnosed patients, 15 (28.3%) had Laser treatment performed and 2 (3.77%) had pars plana vitrectomy (PPV).

Conclusion: Although Priest Hospital sent DR screening postcards to diabetic priests twice, only 176 (42.51%) priests came, and of those, 53 (30.11%) had DR. There is poor co-operation from the priests because of their lack of medical knowledge about DM complication and DR. The priest who came for the appointment were concerned with their health therefore, they had low prevalence of DR with moderate glycemic control. DR in the priests led to low vision (11.83%) and blindness (5.92%). For the priests, adherence to clinical guidelines for glycemic and BP control was low, even in a well-developed health care system with free ophthalmic care access because they cannot select their food and have poor transportation services to health care facilities.

Jenchitr W., Sothornwit N., Srisuwanporn S. et al. Diabetic retinopathy in Priest Hospital. J Med Assoc Thai. 2008;91 Suppl 1:S119-29.