Screening of diabetic retinopathy and maculopathy in Lebanese population using retinography and SD-OCT: The role of telemedicine

Diabetes and diabetic retinopathy (DR) are nowadays a major public health threat. The aim of this study is the screening of DR and diabetic maculopathy (DM) in a primary medical care center in Lebanon. We study also the interest of retinography and of SD-OCT in a telemedicine screening program. This is a transversal study of patients with type 2 diabetes and with a regular follow-up in a primary medical care center in Beirut. For every patient, a retinography and an SD-OCT of the macula were obtained. Photos were sent by Internet to the Ophthalmology Department of Hôtel-Dieu de France to be evaluated by a retina specialist. Visual acuity and DR risk factors were assessed. 119 patients were included in this study. Mean age was 51.7 ± 10.2 years (54 females and 65 males). Mean diabetes duration was 12.15 years (SD 6:2). Mean of last three measurements of glycated hemoglobin was 8.1 ± 1.34%. Diabetic retinopathy was detected in 36 patients by retinography (30.3%). Diabetic maculopathy was confirmed by SD-OCT in 13 patients. Visual acuity was significantly correlated with central macular thickness. Mean diabetes duration, mean of last three measurements of glycated hemoglobin, peripheral neuropathy, positive macroalbuminuria and treatment with insulin were independently associated to diabetic retinopathy. Teleophthalmology is an efficient way for screening diabetic retinopathy in the Lebanese population. National screening program should be undertaken to adapt teleophthalmology on a larger scale.