A Community-Based Telescreening Program to Evaluate Prevalence of Diabetic Retinopathy in Self Reported Diabetic Patients Attending Primary Health Care Hospital in Rural Population in Central India

Objective: The aim of the study was to estimate the prevalence of diabetic retinopathy in a rural population at a PHC using fundus on phone. Design: A community-based cross-sectional study. Participants: 1133 patients were enrolled in a district of Nagpur in Central India. Methods: All patients attending the OPD of PHC with self-reported diabetes underwent examination at the base hospital. The fundus of all patients were photographed using fundus on phone and images were uploaded to cloud via smartphone application. The diagnosis of diabetic retinopathy was based on Early Treatment Diabetic Retinopathy Study. Main Outcome Measures: This included age, gender prevalence of diabetic retinopathy, and correlation of prevalence with duration of disease and history-based risk factors. Results: The prevalence of DR in the population with diabetes mellitus was 10.76% (95% CI) and on the basis of age was maximum in 61-70 years followed by 51-60 years. History-based variables that were not associated with increased risk of DR included gender (men and women are at equal risk); history of IHD, Stroke and smoking status; history of HTN is a risk factor; longer duration of diabetes had higher chance of developing retinopathy. Differences in the socioeconomic status greatly influenced the occurrence of DR. Conclusions: The prevalence of DR was 10.76% in rural population in self-reported diabetics. The combination of affordability, portability easy transmission of images using fundus on phone provides a platform not only for in clinic use but also for mass screening programme in India.