Ophthalmoscopy versus non-mydriatic fundus photography in the detection of diabetic retinopathy in black patients.

Summary The contribution of non-mydriatic fundus Photogr~phYin the detection of diabetic retinopathy before and after dilatation of th~ pU~i1s in black diabetics was investigated and compared with direct ophthalmoscopy. Eighty-six patients were examined and good-quality photographs were obtained for 54,7% of eyes before and 86,6% of eyes after dilatation. Photographically documented retinopathy was detected by ophthalmoscopy in only 64,7% of eyes. The two methods were concordant for the presence of retinopathy in 62,2% of eyes before and 56,9% of eyes after dilatation. Photography through dilated pupils also i.mproved the rate of detection of diabetic retinopathy from 24% to 30%. The 45° non-mydriatic fundus camera was found to be a valuable adjunct in the detection of diabetic retinopathy in a busy diabetic clinic. S Air Med J 1990; 78: 248-250. Diabetic eye disease is a leading cause of blindness in the Western world today, with diabetic retinopathy responsible for 70% of cases of diabetic blindness.! Photocoagulation treat­ ment has been shown to be effective in preserving vision in eyes with proliferative retinopathy as well as diabetic macu­ lopathy.2,3 The prevalence of diabetic retinopathy was found to be ~6,7% ~ a large diabetic clinic, with 9,5% of patients having s~nou~ ret.m.opathy.4 Screening for diabetic retinopathy in any diabetIc clinic should therefore be a maner of priority. Res~onsi?ili~ .for screening for diabetic retinopathy in a busy d.labetlc clinic such as our own often rests solely upon the anendmg doctors. Frequently they are inexperienced and not permanent members of the diabetic team. Furthermore the ability of non-ophthalmologists to identify serious diabetic retinopathy has been questioned. 5 . Several studies have demonsttated the usefulness of a 45° non-mydriatic fundus camera in the detection of diabetic retinopathy through an undilated pupil.