Abstract

Purpose: Early identification of patients at risk for diabetes mellitus (DM) and associated morbidities such as diabetic retinopathy (DR) is essential for effective lifestyle intervention and treatment. Large-scale, cost-effective and minimally invasive screening programs are critical for this purpose. This study evaluated the prevalence and history-based risk factors for DR and whether the non-mydriatic fundus camera is an effective screening method in Turkey at local health centers. Methods: A total of 5182 adults 40 years and older were invited to local health centers in rural Eskisehir, Turkey, for DR risk factor assessment and screening by fundus examination. Fundal images were graded on-site by trained ophthalmology assistants for DR and diabetic macular edema (DME). Patients with DR and DME were referred to the tertiary center for follow-up. Results: The severity of DR was associated with female sex, older age, longer duration of DM, insulin usage, lower body mass index (BMI), lower educational level, higher systolic and diastolic blood pressure and poor control of blood glucose. DR was not associated with alcohol intake or smoking. DME was associated with DM duration and age. Conclusions: Identifying DR prevalence and risk factors are essential for disease control. Non-mydriatic fundus camera imaging proved effective for large-scale DR screening

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