Escola Paulista de Medicina
Postgraduate in Clinical Endocrinology

The feasibility of smartphone based retinal photography for diabetic retinopathy screening among Brazilian Xavante Indians (2020)

Fernando Korn Malerbi ab, AmauryLelis Dal Fabbro c,  João
Paulo Botelho Vieira Filho b,  Laercio JoelFranco bc
 
a Department of Ophthalmology, Escola Paulista de Medicina, Federal University of
São Paulo, Rua Botucatu, 820, CEP 04023-062, São Paulo, SP, Brazil
 b Division of Endocrinology, Escola Paulista de Medicina, Federal University of Sao
Paulo, Rua Estado de Israel, 639, CEP 04022-001, São Paulo, SP, Brazil
c Department of Social Medicine, Ribeirao Preto Medical School, University of Sao
Paulo, Rua Avenida Bandeirantes, 3900, CEP 14049-900, Ribeirão Preto, SP,
Brazil
 
Abstract
Aims
To evaluate the feasibility of smartphone based retinal photography for
diabetic retinopathy (DR) screening among Brazilian Xavante Indians and the
yield of retinal images.
Methods
A non-probabilistic cluster sample of 170 individuals with and without
diabetes was enrolled for ocular examination with a portable retinal camera
during DR screening at two Xavante Reservations. Due to operational
conditions and to optimize the field work, only the larger Xavante villages
were included. Images were obtained after pupil dilation; image analysis
included assessment of quality, presence of media opacities and diabetic
retinopathy grading whenever possible for individuals with diabetes.
Results
A total of 157 individuals underwent the complete ocular imaging protocol, 95
with diabetes (60.5%). Among those with diabetes, 23 (24.2%) could not have
DR graded because of media opacities. For those with gradable images, the
frequency of DR was 22.2%; sight-threatening DR was present in 9.7%. The
main causes for ungradable images were cataracts and asteroid hyalosis.
Conclusions
The presence of DR was higher than in previous studies, calling attention for
its prevention in this vulnerable population. The screening model with a
smartphone-based portable retinal camera is feasible and could increase
screening coverage if associated with telemedicine.
 

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