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Original article
Diabetic retinopathy screening and treatment in Myanmar: a pilot study
  1. Sarju Patel1,
  2. Richard M Klein2,
  3. Arun Patel3,
  4. Ronnie Boriskin Klein4,
  5. Mya Aung5,
  6. Wilbert Hoe5
  1. 1 Ophthalmology, Weill Cornell Medical College, New York, USA
  2. 2 Department of Ophthalmology, Yeshiva University Albert Einstein College of Medicine, Bronx, New York, USA
  3. 3 Department of Ophthalmology, Retinal Consultants, Sacramento, California, USA
  4. 4 Department of Philosophy, Fordham University, New York, USA
  5. 5 Department of Ophthalmology, Sitagu international Missionary Association, Sagaing Hills, Sagaing, Myanmar
  1. Correspondence to Dr. Richard M Klein; richardmklein{at}gmail.com

Abstract

Background/aims The goals of this pilot study were (a) to demonstrate the feasibility of identifying patients with vision-threatening diabetic retinopathy (DR) in a provincial area of Myanmar and treating them with portable lasers and (b) to gather data specific to Myanmar to help design larger cross-sectional studies of DR prevalence in Myanmar.

Methods 97 consecutive patients with diabetes mellitus (DM) were identified by local ophthalmologists over a period of 1 month in Pyinmana, Myanmar and were referred to the pilot screening programme. Patients’ demographics were recorded and their eyes were examined. Those with vision-threatening DR were treated with panretinal photocoagulation (PRP).

Results Of the 97 patients with DM, 33 (34%) had evidence of DR, 23 (23.5%) had evidence of vision-threatening DR including 13 (13.5%) with proliferative DR and 33 eyes in 23 patients (23.5%) had PRP with portable green wavelength laser. Hypertension was a significant cofactor in the development of vision-threatening DR (p<0.01). The average time since diagnosis of DM was 6.0 years in patients with vision-threatening DR.

Conclusions This study demonstrates the feasibility of identifying and treating patients with vision-threatening DR in a provincial area of Myanmar and provides initial data to plan a larger study to assess true prevalence, a prerequisite for establishing broader screening/treatment programs.

  • Retina
  • Public Health
  • Epidemiology
  • Treatment Lasers

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

https://doi.org/10.1136/bmjophth-2017-000084

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    Footnotes

    • Acknowledgements The authors gratefully acknowledge the support of the Sitagu International Buddhist Association. A prime reason for the success of this pilot programme was the existence of a network throughout Myanmar of modern eye clinics (and affiliated local ophthalmologists) established by the Sitagu International Buddhist Missionary Association. We also wish to thank the staff of the Sangha Hospital, a provincial hospital affiliated with the Sitagu Association.

      Our gratitude also goes to the staff of the Sitagu Ayudana Hospital, to SEE International, the Alcon Corporation and the many physicians in Myanmar who helped in this study.

    • Contributors All authors contributed significantly to the design and to the carrying out of the study. All authors contributed significantly to the manuscript preparation.

    • Competing interests None declared.

    • Patient consent No information is present in this study identifiable as being from a specific patient. Treatment modality and treatment indications used in the study represent the widely accepted standard of care for diabetic retinopathy.

    • Ethics approval Weill Cornell Medical College IRB.

    • Provenance and peer review Not commissioned; internally peer reviewed.