Between 20% and 50% of diabetic patients are not being screened for retinopathy often enough. It is a surprising statistic given that at least one third of diabetic patients will develop the disease.
Endocrinologist and Clinical Dean of Medicine at the University of Melbourne Professor Richard O’Brien says eye disease can be prevented if people are screened regularly and the damage is caught early.
“There are no symptoms of eye disease early in the process and it’s not until it’s too late that people start to experience problems with their vision,” says Professor O’Brien.
“Even today, I see people who have diabetes and are unaware of the need for an eye checkup. In our Indigenous population, screening rates are much worse.”
To hear more about preventing and managing diabetic retinopathy from Professor Richard O’Brien, sign up here for Healthed’s upcoming webinar.
Screening should be done every two years, provided the diabetic patient shows no signs of retinopathy.
“If there is eye disease present, the recommendation is once every 12 months,” Professor O’Brien says.
“If there is more significant disease present, screening will be more frequent, but that would be advised by the optometrist or ophthalmologist.”
Urban GPs can refer patients to an optometrist for eye screening. Professor O’Brien says rural GPs might opt to use handheld retina cameras to screen themselves, particularly where an optometrist or ophthalmologist is far away.
“The important thing is to check the patient has actually been screened, because sometimes we advise patients to do it and they forget and slip through the cracks,” he says.
To help GPs keep on top of patient screening, Professor O’Brien recommends the KeepSight program, which is led by Diabetes Australia and integrated with the National Diabetes Service Scheme (NDSS).
If a patient with type 2 diabetes exhibits early-stage diabetic retinopathy, evidence from the FIELD and ACCORD studies shows the drug fenofibrate can reduce disease progression by 30-40%.
“Many doctors will know fenofibrate as a drug that’s used to lower triglycerides, but it doesn’t matter if people have high or normal triglycerides, fenofibrate is still effective,” says Professor O’Brien. Fenofibrate is currently also being trialled for patients with type 1 diabetes.
Lower blood glucose levels can also help reduce the progression of diabetic retinopathy, Professor O’Brien says, as can good blood pressure and cholesterol levels, and stopping smoking.
To hear more about preventing and managing diabetic retinopathy from Professor Richard O’Brien, sign up here for Healthed’s upcoming webinar.
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