Screening for diabetic retinopathy using the mobile retinal camera: the Waikato experience

To report the results of the Waikato Regional Mobile Diabetic Retinopathy Photoscreening Programme.

We audited the results of a diabetic retinal photoscreening programme using the mobile retinal camera in the Waikato region for the period August 1993 to December 2001.

A total of 8172 patients were screened one or more times, with a total of 15 555 photoscreens, representing approximately 79% of the expected number of patients with diabetes for the region. Seventy eight per cent showed no diabetic retinopathy (NDR), 9.3% had evidence of non-vision-threatening retinopathy (NVR), and 3.1% had evidence of vision-threatening retinopathy (VTR). A further 2281 (14.7%) led to a referral to an eye clinic for specialist review. The percentage of all screening episodes resulting in VTR fell from 11.5% in 1993 to 1.5% in 2002. The overall failure-to-attend rate for photoscreening was high (18.7%), especially in the Maori population (32.3%).

Mobile retinal photoscreening is practical in a large rural area, and its implementation has been associated with a reduction in presentations with vision-threatening retinopathy within the total community. The rate of subsequent development of VTR in the group with normal eyes on initial photoscreening was low and supports a two-yearly repeat photoscreening schedule for this group. Despite significant efforts to improve physical access to photoscreening, the failure-to-attend rates in all ethnic groups other than Europeans are disappointingly high.