OBJECTIVE : The aim of the study was to determine the prevalence
of diabetic retinopathy, maculopathy and visual loss in
primary care patients and to identify associated risk factors.
RESEARCH DESIGN AND METHODS : We conducted a cluster randomised
trial at primary care clinics in the Tshwane district
in South Africa. Grades of retinopathy and maculopathy
(with fundus camera) and visual acuity (Snellen chart) were
assessed and, using mobile screening and teleophthalmology,
clinical and biochemical testing was conducted to obtain
information about glycaemic control and microvascular
complications. RESULST : The prevalence rates for any retinopathy,
preproliferative retinopathy and proliferative retinopathy
were 24.9, 19.5 and 5.5%, respectively. The prevalence
rates of diabetic maculopathy, observable maculopathy and
referable maculopathy were 20.8, 11.8 and 9.0%, respectively.
The presence of retinopathy was associated with high
body mass index, systolic blood pressure, being on insulin
treatment, high HbA1c and the presence of neuropathy.
High systolic blood pressure, being on insulin treatment,
high HbA1c level and high low-density lipoprotein choles- terol level as well as the presence of albuminuria were significant
in predicting any diabetic maculopathy. Laser photocoagulation
was given to 8.3% of patients from the mobile
unit and 12% of patients were referred to the nearest hospital
with an outpatient eye clinic for follow-up treatment of
various other eye conditions. Using the WHO categories, the
study found that 78.1% of diabetes patients had normal vision,
19.3% were visually impaired and 2.2% were severely
impaired or blind. CONCLUSION : High prevalence rates for diabetic
retinopathy, maculopathy and visual loss were found
and associations were identified.