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Systematic screening for diabetic retinopathy (DR) in Hong Kong: prevalence of DR and visual impairment among diabetic population
  1. Jin Xiao Lian1,2,
  2. Rita A Gangwani1,
  3. Sarah M McGhee3,
  4. Christina K W Chan1,
  5. Cindy Lo Kuen Lam2,
  6. Primary Health Care Group,4,
  7. David Sai Hung Wong1
    1. 1Department of Ophthalmology, The University of Hong Kong, Hong Kong, Hong Kong
    2. 2Department of Family Medicine and Primary Care, The University of Hong Kong, Hong Kong, Hong Kong
    3. 3School of Public Health, The University of Hong Kong, Hong Kong, Hong Kong
    4. 4Department of Family Medicine and Primary Health Care, Hospital Authority, Hong Kong, Hong Kong
    1. Correspondence to Dr Rita A Gangwani, Department of Ophthalmology, The University of Hong Kong, Room 301, Block B, Cyberport 4, 100 Cyberport Road, Hong Kong, Hong Kong; gangwani{at}, dr.rita_gangwani{at}


    Purpose To determine the prevalence of diabetic retinopathy (DR), sight threatening DR (STDR), visual impairment and other eye diseases in a systematic DR screening programme among primary care Chinese patients with diabetes mellitus (DM) in Hong Kong.

    Methods Screening for DR was provided to all subjects with DM in public primary care using digital fundus photography according to the English national screening programme. STDR was defined as preproliferative DR (R2), proliferative DR (R3) and/or maculopathy (M1). The presence of other eye diseases was noted. Visual impairment was classified as none (visual acuity in the better eye of 6/18 or better), mild (6/18 to >6/60) and severe (6/60 or worse).

    Results Of 174 532 subjects screened, most had never been screened before. The prevalence of DR was 39.0% (95% CI 38.8% to 39.2%) and STDR 9.8% (95% CI 9.7% to 9.9%). The most common DR status was R1 (35.7%), followed by M1 (8.6%), R2 (3.0%) and R3 (0.3%). The prevalence of mild and severe visual impairment was 4.2% and 1.3%, respectively. Subjects with STDR had a higher prevalence (9.8%) of visual impairment than those without (3.5%).

    Conclusions DR was prevalent in this population and one in 10 had STDR. This suggests the need for systematic screening to ensure timely referral to an ophthalmologist for monitoring and/or treatment.

    • Retina
    • Public health
    • Epidemiology
    • Vision

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