[Prevalence of diabetic retinopathy. Check-up program of a public health insurance company in Germany 2002-2004]

Abstract

Objectives: Population based studies have reported a prevalence of diabetic retinopathy (DR) at the time of diagnosis in up to 30% of the patients. In the context of a general diabetes check-up program (so called "Diabetes-TUV"), the prevalence of diabetic retinopathy in Germany was examined in all diabetes patients insured in a public health insurance company.

Methods: Patients were screened in the offices of 181 ophthalmologists according to a standardized protocol formulated by Prof. Kroll, Marburg. A total of 6,500 sheets were analysed out of which 14.5% were multiply documented. The latest protocols of 5,596 patients were evaluated; the mean age was 64.7 years with an average duration of diabetes of 10.2 years.

Results: Some 86.3% of the eyes examined had no DR, in 3.1% no evaluation was possible. Of the patients checked, 10.6% had DR. Mild/moderate DR was reported in 8.3%, severe non-proliferative DR in 1.7% and proliferative DR in 0.5%. Macular edema was reported in 0.85% of cases, vitreous hemorrhage in 0.2%. There was 0.1% iris neovascularisation and 0.1% retinal detachment. Visual impairment due to cataract or secondary cataract was found in 25.2% of patients with an 8.3% pseudophakia rate.

Conclusion: Documentation of the eye examination in the diabetes check-up program was good. The 10.6% prevalence of DR in Germany, even after long standing diabetes, seems to be lower than in earlier population based studies in the US or UK. The data reported here could be an indication of better diabetes care in Germany. However, not all patients were examined with dilated pupils, and in the case of severe changes, the ophthalmologist might have decided not to fill in the report form and to have chosen another form of communication.