Diabetic retinopathy in a hospital eye clinic population in Honiara, Solomon Islands

Abstract

To determine the presence, severity and context of diabetic retinopathy among diabetic adults using hospital eye clinic services in Honiara, Solomon Islands. Fifty consecutive known diabetic patients aged ≥20 years were interviewed and underwent Snellen distance vision testing and complete ocular examination, including dilated 90 D funduscopy. Diabetic retinopathy was graded according to the International Clinical Diabetic Retinopathy and Macular Oedema Disease Severity Scales. Participants were predominantly Melanesian (94%). Mean age was 53.6 ± 10.7 years; 42% were female; and 34% were rural dwellers. Diabetes had been diagnosed <5, 5-10 and >10 years ago for 42%, 34% and 24% of participants. However, 54% denied ever having had a dilated fundus examination. Proliferative retinopathy, severe non-proliferative changes and maculopathy were present in 5, 12 and 26 eyes, respectively. For the 32 eyes with pinhole acuity ≤6/12, diabetic eye disease was the cause for 20, with all but one due to maculopathy. Diabetes reduced the pinhole vision of five eyes to ≤6/60. Twenty-four per cent of participants had diabetes-related pinhole vision ≤6/12 in at least one eye. Those diagnosed with diabetes 5-10 and >10 years were 17.5 and 58.8 times more likely to have such an eye compared with those recently (<5 years) diagnosed (extended Mantel-Haenszel χ² = 11.570, P < 0.001). Participants were not well informed about diabetic eye disease. Diabetic eye disease is now a significant contributor to this clinic's workload. A population-based survey is needed to quantify the problem and inform design and delivery of eye services for this chronic disease.