Two-field mydriatic fundus photography to assess the prevalence of macular disorder in diabetes
Authors:   LLC ", Avanesova T.A. ,   Liga+”, Reutov, Russian Federation,   LLC "Eye Microsurgery Center of Moscow Region", Sergiev Posad, Russian Federation, Oganezova J.G. ,   Pirogov Russian National Research Medical University, Moscow, Russian Federation,   Research Center for Medical Genetics, Moscow, Russian Federation, Anisimova V.V. ,   Central Clinical Hospital and Polyclinic of the Department for Presidential Affairs, Moscow, Russian Federation, Baeva A.B. ,   Pirogov Russian National Research Medical University, Moscow, Russian Federation,   Hospital for War Veterans No. 2, Moscow, Russian Federation, Miaev D.H. ,   LLC "Liga+”, Reutov, Russian Federation
Published: September 2024

Aim: to evaluate the prevalence of macular dysfunction in patients with type 1 (T1D) and type 2 diabetes (T2D) of different age and sex based on fundus photographs. Materials and Methods: this work is part of a study involving medical institutions of five cities of the Russian Federation. 367 patients with diabetes (34.88% males and 65.12% females; mean age 50.88±20.55 years) were enrolled, including 34.88% with T1D and 65.12% with T2D. The mean disease duration was 9.02±7.22 years. 58.31% of the patients had a history of hypertension and 13.08% a history of smoking. The ophthalmologists evaluated two-field fundus photographs and graded the changes as M0 (no diabetic changes in the macula) or M1 (diabetic changes in the macula). Non-diabetic changes were not included in the analysis. The presence of exudates, microaneurysms or hemorrhages within 1 DD from the center of the fovea, circular or clustered exudates in the macular area were evaluated. Results: diabetic maculopathy (DM) was found in 47 (12.81%) patients. DM was associated with diabetic retinopathy (DR) in 18 (4.90%) patients. DM was mainly observed in patients with T2D (15.90%), in women (8.45%) and bilaterally (8.17%). There were no significant differences in visual acuity between patients with and without diabetes. There was a trend towards an increased prevalence of DM in older patients with a history of T2D of 15–25 years (p>0.05). No significant differences were found in the incidence of DM and DM+DR according to glycated hemoglobin (HbA1c) levels. DM developed in 11.11% of patients with HbA1c≤7.5% and in 15.79% of patients with HbA1c>7.5% (p=0.260). There was a trend towards an increased prevalence of DM in smokers (20.83% vs. 11.60% in non-smokers, p=0.120). Elevated blood pressure did not affect the incidence of DM. Conclusion: these findings (some of which were presented in the previous publication and will be presented in the next one) emphasize the efficacy of two-field mydriatic fundus photography as a screening tool for diabetic retinopathy and maculopathy. KEYWORDS: diabetes, retina, diabetic maculopathy, diabetic retinopathy, diabetic macular edema, screening, fundus photography, prevalence, two-field photography, risk groups. FOR CITATION: Avanesova T.A., Oganezova J.G., Anisimova V.V., Baeva A.B., Miaev D.H. Two-field mydriatic fundus photography to assess the prevalence of macular disorder in diabetes. Russian Journal of Clinical Ophthalmology. 2024;24(3):102–108 (in Russ.). DOI: 10.32364/2311- 7729-2024-24-3-1.