The Santa Barbara County diabetic retinopathy screening feasibility study: significance of diabetes duration and systolic blood pressure

Abstract

The objective of this study was to examine the feasibility and utility of screening for eye disease and hypertension in a group of diabetic patients. A sample of 338 outpatients in Santa Barbara County were included and had non-mydriatic retinal photography and measurement of blood pressure and visual acuity. Each patient completed a questionnaire including age, type of diabetes (type I or type II), duration of diabetes, and smoking history. Photographs were read by an internist and ophthalmologist, and grouped into one of five categories: (1) normal, (2) background retinopathy, (3) preproliferative retinopathy, (4) proliferative retinopathy, and (5) other abnormality. Patients with abnormalities were referred for treatment. Thirty-two percent of the population had retinopathy, and 16% had disease requiring urgent referral for treatment. Mean systolic blood pressure (MSBP) was found to be higher in patients with all types of retinopathy (132 mm Hg versus 124 mm Hg, p < 0.001). The relationship remained significant when smokers and nonsmokers were considered separately. No significant difference was found in MSBP between patients with severe retinopathy (preproliferative or proliferative) and those with background changes (133 mm Hg versus 131 mm Hg, respectively, p > 0.5). The other factor found to be related to retinopathy was the duration of diabetes. Type I patients with retinopathy had diabetes for 19 years versus 12 for those without (p < 0.01). Type II patients with retinopathy had diabetes for 10 years versus 6 for those without retinopathy (p < 0.02).(ABSTRACT TRUNCATED AT 250 WORDS)