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Impressum
Photoscreening for diabetic retinopathy in maori and polynesians
Klais C. M. C., Donaldson M. L., Gruptchev I., Clover G., McGhee C. N. J.
Department of Ophthalmology, University of Auckland, Private Bag 92019, Auckland, New Zealand
Introduction: Diabetes type II prevalence in Maori and Polynesians
is not only increased 2 to 4 fold, as compared to Caucasians, but also
occurs at relatively young age. Advanced microangiopathy, combined with
severe maculopathy can often be observed after only a few years of disease.
The largest Polynesian population worldwide resides in South Auckland.
In 1989, a diabetes screening program was launched by the university of
Auckland.
Background: Healthcare is publicly funded and is free for all inhabitants
of New Zealand. There are waiting lists for treatment and specialist consultations
and priorities are made based on a rating scheme. The high prevalence
of diabetes among Polynesians and Maori requires a cost - effective screening
program for diabetic retinopathy.
Method: Diabetic patients are referred to the South Auckland Superclinic
by the neighboring hospitals, diabetes centers and general practitioners.
Patient history and visual acuity are assessed. Retinal images are recorded
digitally. The evaluation of retinal images is performed by ophthalmologists
based on standardized criteria. Based on this evaluation, the patient
may either be immediately referred for a retina consultation, to the ophthalmological
outpatient clinic, to an optometrist, continue to be photoscreened at
set intervals (between 3 and 24 months) or enrolled on a waiting list
for laser therapy.
Discussion: The superclinic's screening-program for diabetic retinopathy
has proven to be of value in the special New Zealand setting. It allows
provision of service to diabetics at any point in time, with the appropriate
treatment options ,while addressing cost-effective requirements.