VOLUME 7 NUMBER 3 • SEPTEMBER 2010
121
SA JOURNAL OF DIABETES & VASCULAR DISEASE
One would have to divide the referrals into urgent and routine. Screen-
ing follow-up protocols would also need to be devised. A contact system
would be different for those from an urban and rural background due to
communication difficulties in rural areas.
In parts of the UK, patients are posted annual invitations for their di-
abetic screening; the so-called ‘call and recall’ system. In South Africa
some form of electronic message may be more appropriate, such as SMS
or e-mail.
Photography and screening centre
Studies indicate that the most appropriate place to have such a centre
would be adjacent to the primary-care physician’s rooms or clinic. Screen-
ing is least threatening if it forms part of the routine diabetic check up.
Compliance is optimal in this setting.
18,19
Essential for the service to func-
tion properly is the appropriate back-up service of the camera. It would
need to be replaced temporarily at short notice if there was camera fail-
ure. This would have to be part of the sales agreement with the provider.
Quality assurance
Essential to any screening programme is quality control and audit. One
needs to identify the pick-up rate of the programme and monitor the pho-
Hands On
More than 20 years service to South African and African markets
Eurotech Optical, established in South Africa in 1989, has grown to be a serious contender within the optical industry
Eurotech supplies the Kowa non-myd 7 (12 megapixel) and the Kowa non-myd 7 WX (3-D) fundus cameras at affordable prices.
Kowa Instruments have been active in the opthalmological market for more than 100 years, supplying a global market.
Eurotech also supplies the Kowa VK2 digital opthalmic imaging system, which expands imaging management systems in
opthalmological practices and is capable of integrating images from three cameras at once.
Non-myd 7
Does anterior and posterior photography
Free mosaic (montage) software included
Three-point internal fixation to
use with the montage software
Nine-point fixation target
(optional) to use with the
montage software
New embossing feature
Two angles: 20 and 45 degrees
Stereo photography available
Cup/disk measurement by angle
or points
Award-leading camera system
from NIKON
Non-myd 7 WX
Does anterior and posterior photography
The world’s first and only 3-D non-mydriatic fundus camera – take one image with the first shot and display two
different images at two different angles three dimensionally
Nine-point internal fixation lights enables nine different angles to be taken with mosaic (montage) feature – automatic
mosaic merge feature with automatic image rotation and alignment
The only non-mydriatic fundus camera with disk-damage likelihood
scale-depth distribution for the graphical display or the cross section
of an arbitrary position
Two angles: 20 and 45 degrees
New embossing feature
Numerical display of optic disc parameters
Polar coordinates display of the depth distribution permits visual
display of the thin part of the rim
Contour line depth distribution of cup and disc profiles
Follow up of graphical display of cup/disc
Award-leading camera system from NIKON
Cup/disk measurement by angle or points
Tel: (012) 370-4175/ 3383/ 3951;
0861 3876 8324 / 0861 EUROTECH
Solly Moosa – 076 454 0930
Ahmed – 082 414 1472
e-mail:
tography and reading. The referral and follow-up pattern needs to identify
deficiencies so that these can be addressed.
Conclusion
In order to ensure better management of diabetic retinopathy, there is
a need for a screening programme in KwaZulu-Natal and other parts of
South Africa where this service does not exist. Many patients who present
to ophthalmology departments with inoperable disease would not have
reached this advanced stage if they had been identified earlier.
DR screening is an essential part of a comprehensive management plan
for diabetic patients. In order to plan correctly, a pilot project would be
the ideal starting point. A customised system could then be created that
would manage the ever-increasing burden of disease in our unique setting.
continued on page 129 …
Key points
•
The magnitude of the disease and the efficacy of early treatment
warrant the implementation of a screening programme.
•
Studies indicate that a photograph through the undilated pupil is
comparable as a screening tool for diabetic retinopathy.
