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Evaluating the management of diabetic retinopathy in a teaching center
N M Pharmakakis1, I K Petropoulos, P A Peristeropoulos
1Department of Ophthalmology, University of Patras, Patras, Greece. npharmak@med.upatras.gr
Purpose:
To evaluate the efficacy of the management of diabetic retinopathy (DR) in the teaching center of the University Eye Clinic of Patras in Greece.
Methods:
From 1989 to 1999, 302 patients with type I (5.3%) and type II (94.7%) diabetes mellitus (DM) were examined. Standard examination and treatment protocols were employed. Examinations and laser treatment were done by trainee specialists, under the supervision of the head physician (N.Ph), during their rotation in the retina and vitreous disorders outpatient department.
Results:
At baseline examination, 17.9% of the eyes had no DR, 71.7% had nonproliferative DR, and 10.4% had proliferative DR. In 34.4%, no laser treatment followed. The other 65.6% underwent focal and/or grid laser and/or panretinal photocoagulation and/or vitrectomy. At the final examination, DR was still the same in 63.1% of the eyes, progression had occurred in 34.1%, and regression in 2.8%. Type I DM patients' eyes had a higher prevalence of proliferative DR at the final examination than type II DM eyes. There was also a significant correlation between progression of DR and duration of DM, insulin treatment for DM, and elevated glycosylated hemoglobin (HbA1c).
Conclusions:
Having applied standard examination and treatment protocols, the efficacy of the management of our diabetic patients was consistent with international standards, even though patients were treated mostly by doctors in training.