Poster Presentation Australasian Diabetes in Pregnancy Society and Society of Obstetric Medicine Australia and New Zealand Joint Scientific Meeting 2021

Incorporation of diabetic retinopathy screening into an antenatal clinic (#64)

Jessica L Phillips 1 , Vignesh Raja 2 , Chhaya Mehrotra 1 , Josephine Richards 3 , Jane Khan 3 , Me Ko 2 , Dorothy F Graham 1 4
  1. King Edward Memorial Hospital, Shenton Park, WA, Australia
  2. Department of Opthalmology, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia
  3. Department of Opthalmology, Royal Perth Hospital, Perth, Western Australia, Australia
  4. University of Western Australia, Perth, Western Australia, Australia

Background: Early recognition of diabetic retinopathy (DR) is essential to avoid irreversible vision loss. Pregnancy is an independent risk factor for progression of DR however, pregnant women with pre-gestational diabetes often fail to meet the recommended screening targets. Known barriers to screening in pregnancy include the logistical difficulties of attending multiple medical appointments and ease of access to screening facilities. Non-mydriatic retinal photography is an accepted modality for DR screening. It does not require significant training for the operator, avoids pupil dilation and creates a permanent record of retinal appearances.

Objective: to describe our experience of the introduction of a retinal camera to the multidisciplinary diabetes clinic at a tertiary maternity hospital and to compare maternal retinal screening rates before and after the camera’s introduction.

Methods: A retinal camera was installed at King Edward Memorial Hospital (KEMH) in 2020. Patient characteristics, diabetic retinopathy (DR) screening and retinopathy diagnosis rates before and after camera installation were recorded for all pregnant women with pre-gestational type 1 or type 2 diabetes who received pregnancy care at KEMH from March 2020 to January 2021.

Results: A total of 174 women were included in the study. The only significant difference in baseline patient characteristics between the two groups was in glycosylated haemoglobin in the 3rd trimester. There were significantly more women who received at least one retinal screen for DR following the installation of the retinal camera (93.0% vs 54.3% p=<0.001). The identification of DR and DR progression also increased significantly in the post-retinal camera group.

Conclusion: The introduction of an onsite retinal camera to a diabetes in pregnancy clinic significantly increased the number of women receiving appropriate retinal screening, the identification of DR and of DR progression. The use of a retinal camera in similar antenatal clinics is a feasible option to improve outcomes.