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July 2011


Nondiabetic retinal pathology

Prevalence in diabetic retinopathy screening

Volume 40, No.7, July 2011 Pages 529-532

Nondiabetic retinal pathologyNathan Nielsen MBBS(Hons), BAppSc(Hons), is Resident Medical Officer, Princess Alexandra Hospital, Brisbane, Queensland.

Claire Jackson MBBS, FRACGP, MPH, MD, is Professor of General Practice and Primary Health Care, Discipline of General Practice, The University of Queensland

Geoffrey Spurling MBBS, MPH, FRACGP, Senior Lecturer, Discipline of General Practice, The University of Queensland, Brisbane, QLD

Peter Cranstoun MBBS(Hons), FRANZCO, is an ophthalmologist, Pine Rivers Eye Centre, Brisbane, Queensland.


To determine the prevalence of photographic signs of nondiabetic retinal pathology in Australian general practice patients with diabetes.


Three hundred and seven patients with diabetes underwent retinal photography at two general practices, one of which was an indigenous health centre. The images were assessed for signs of pathology by an ophthalmologist.


Signs of nondiabetic retinal pathology were detected in 31% of subjects with adequate photographs. Features suspicious of glaucoma were detected in 7.7% of subjects. Other abnormalities detected included signs of age related macular degeneration (1.9%), epiretinal membranes (2.4%), vascular pathology (9.6%), chorioretinal lesions (2.9%), and congenital disc anomalies (2.9%). Indigenous Australian patients were more likely to have signs of retinal pathology and glaucoma.


Signs of nondiabetic retinal pathology were frequently encountered. In high risk groups, general practice based diabetic retinopathy screening may reduce the incidence of preventable visual impairment, beyond the benefits of detection of diabetic retinopathy alone.

Retinal photography is an accepted method of screening for diabetic retinopathy (DR), and is especially useful in situations where there are barriers to accessing regular eye care services.1,2 Utilising general practitioners to conduct such screening may help to increase access for patients in situations where barriers exist. Many patients who attend DR screening will have ocular pathology unrelated to their diabetes, and detecting this may add extra value to the DR screening process.3 Indeed, the majority of cases of vision loss in patients with diabetes are due to causes other than DR.4

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