Findings of diabetes eye screening in Brunei Darussalam: REPAS diabetic retinopathy grading scale

 

Nadir Ali Mohamed ALI 1, 2, Joshua GEORGE 1, 2, Nayan JOSHI 2, Ming Sheng LIM 1, 3, Azimuddin Azim SIRAJ 4

1 Vitreoretinal Unit, RIPAS Eye Centre, RIPAS Hospital, 2 Brunei National Programme for Prevention of Diabetic Blindness, Ministry of Health, 3 Community Ophthalmology Department, RIPAS Eye Centre, RIPAS Hospital, and 4 Ophthalmology Department, Suri Seri Begawan Hospital, Kuala Belait, Brunei Darussalam

 

ABSTRACT

Introduction: Diabetes mellitus is very common and increasing globally. Diabetic retinopathy is a common complication and regular eye check is recommended. The aim of this study is to present our findings with diabetes eye screening using our newly designed REPAS diabetic retinopathy grading scale, and the improvement it brought to the documentation, management, statistical analysis, supervision and monitoring of diabetic eye screening activities in Brunei Darussalam. Materials and Methods: REPAS grading scale for diabetic retinopathy is a result of intra- and inter-departmental discussions involving the National Programme for Prevention of Blindness (Brunei Darussalam), Community Ophthalmology, secondary and tertiary eye care units nationwide. Attendees of the preliminary discussion groups held agreed on the need for a standardised, easy to analyse scoring system for diabetic retinopathy. The system was launched in February 2013, and gradually migrated to BruHIMS. A pilot cross-sectional study was conducted in the month of September 2014 to assess the integrity and the usefulness of the system from the user point-of view as well as from administrative perspective. Diabetic patients seen for eye screening in all health facilities of Brunei were included. PubMed literature review and study of other countries experience was discussed. Results: A total of 1,184 diabetic patients were screened for diabetic retinopathy across the country in the month of September 2014. Of those, 698 (59%) were females and 782 (66%) were Malay. The highest number of attendances for diabetic retinopathy screening was seen in RIPAS hospital (18%), followed by Suri Seri Begawan Hospital (15.7%) and PAPHMWHB Health Centre (12.4%). In terms of retinopathy, Majority of patients seen did not have diabetic retinopathy (81.5%), while only 3.7% of the patients had severe non-proliferative diabetic retinopathy or worse. Conclusion: REPAS diabetic retinopathy grading scale is a feasible diabetic eye screening module in the consensus of Brunei’s health system. It showed great potential for quality improvement of diabetic eye screening in the country.  

 

Keywords: Diabetic retinopathy, macular oedema, grading scale, screening

 

Correspondence auhtor: Nadir ALI, Vitreoretinal Unit, RIPAS Eye Centre, RIPAS Hospital, BA1710, Bandar Seri Begawan, Brunei Darussalam

Tel: +673-8223690,

E mail: nadiramali@hotmail.com

 

Brunei Int Med J. 2015; 11 (4): 182-190

BACK TO CONTENTS