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Journal of Diabetes Research
Volume 2016, Article ID 4101890, 10 pages
Research Article

Diabetic Retinopathy Screening Ratio Is Improved When Using a Digital, Nonmydriatic Fundus Camera Onsite in a Diabetes Outpatient Clinic

1Department of Medicine I and Clinical Chemistry, University Hospital Heidelberg, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany
2Department of Endocrinology and Diabetology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246 Hamburg, Germany
3Department of Ophthalmology, University Hospital Heidelberg, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany
4Department of Medicine, Kantonsspital Olten, Baslerstrasse 150, 4600 Olten, Switzerland

Received 31 May 2015; Revised 28 August 2015; Accepted 6 September 2015

Academic Editor: Ahmed Ibrahim

Copyright © 2016 Pia Roser et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Objective. To evaluate the effect of onsite screening with a nonmydriatic, digital fundus camera for diabetic retinopathy (DR) at a diabetes outpatient clinic. Research Design and Methods. This cross-sectional study included 502 patients, 112 with type 1 and 390 with type 2 diabetes. Patients attended screenings for microvascular complications, including diabetic nephropathy (DN), diabetic polyneuropathy (DP), and DR. Single-field retinal imaging with a digital, nonmydriatic fundus camera was used to assess DR. Prevalence and incidence of microvascular complications were analyzed and the ratio of newly diagnosed to preexisting complications for all entities was calculated in order to differentiate natural progress from missed DRs. Results. For both types of diabetes, prevalence of DR was 25.0% () and incidence 6.4% () (T1DM versus T2DM: prevalence: 35.7% versus 22.1%, incidence 5.4% versus 6.7%). 25.4% of all DRs were newly diagnosed. Furthermore, the ratio of newly diagnosed to preexisting DR was higher than those for DN () and DP () representing at least 13 patients with missed DR. Conclusions. The results indicate that implementing nonmydriatic, digital fundus imaging in a diabetes outpatient clinic can contribute to improved early diagnosis of diabetic retinopathy.