Cribado de la retinopatía diabética mediante teleoftalmología en una zona básica de salud rural

OBJECTIVE: To investigate the prevalence of diabetic retinopathy in a rural health basic area, and to establish the type, the severity degree and the relationship with sex and with another cardiovascular risk factors. DESIGN: Cross-sectional or prevalence descriptive study. LOCATION: Rural health basic area in Spain. Primary health care level. PARTICIPANTS: 500 patients over 18 years old with diabetes. MAIN MEASUREMENTS: Study of the retina through retinography under mydriasis, according to the Joslin Vision Network protocol, with the incorporation of a diagnostic reading center. Correlation of the existence and severity of the retinopathy with the cardiovascular risk factors –smoking, hypertension and hyperlipidemia– and the characteristics of the diabetes –type, evolution time, treatment, metabolic control and renal function–. RESULTS: The findings showed a 16.4% prevalence, with no significant differences between both sexes. The variables smoking and high blood pressure were related to the existence of retinopathy, and the variable years of diabetes evolution was correlated to both the existence and the severity of the retinopathy. In the study, 9.6% of the affected people were preferentially referred to the ophthalmologists because of sight-threatening retinopathy, and 6.8% of the people studied were referred due to other ophthalmological pathologies. CONCLUSIONS: It is possible to do the ophthalmological follow-up of 82% of the population with diabetes in primary health care, involving its professionals and team-working with the ophthalmologists. It is paramount to consider diabetic retinopathy within the global context of the person with diabetes, relating diabetic retinopathy with the other microvascular complications and cardiovascular diseases.