Advanced diabetic retinopathy

ophthalmologist, endocrinologist or patient responsibility

N Madaidou; H Tahiri; S Jihad; A Chakib; K Zaghloul; A Amraoui. Ophthalmology Department Casablanca Morocco

6,6% more than 20 years old. 10% after 50 years. Two millions diabetics in our country. 25% diagnosis by complications. First cause of blindness before 50years old.

Diabet a true epidemy. epidemy.

RESULTS 30 cases, spread out over 2 years. Main age : 36 years. Low socio-economic level without Social Security cover++. 19 patient not insulinodependant. The average of evolution of the diabet: 11 yaers . High blood pressure:15 patients. Dyslipidemia: 5 cases. Nephropathy in 10 cases (4 hemodialyzed). 10 followed by a generalist ( never done an ophthalmologic examination).

5 never done a angiography. 15 followed by ophthalmologist (angiography+laser). The visual acuity:.

accounts the fingers at 3 metres: 50%. hand mouvement: 35%. positive light perception 15%.

5 monophtalm patients. 8 have a neovascular glaucoma. The fundus examination: complicated proliferative diabetic retinopathy: retinal detachement; vitreous
hemorrhage; ischemia. Treatment: cyclocryoapplication : 20 cases; abstention : 10 cases.

DISCUSSION

Complicated diabetic retinopathy:

common and most serious. third of diabetic affected. functional complication low vision or blindness.

Socio-professional and economic consequences. Nephropathy diabetic with renal insufficiency 15% mortality Laser-photo-coagulation

AIMS SelfSelf-control. Control cardiovascular risk factors. cardiovascular Educational programs. Hygieno-dietetic rules. ygienoEarly detection and treatment. Recommended ABC Targets:
A1C - less than 7 percent. Blood pressure - below 130/80. Cholesterol (LDL) - below 100.

DIFFICULTIES

15 % only with a social security cover. Poverty and illiteracy+++. Children and adults++. Insulin cost doubled (human insulin).
Insulin bottle costs 120 dh 30 dh in Tunisia Cost : 400-600/ month

130 endocrinologists for a 30 millions morrocans.

CONCLUSION

The existence of these forms of diabetic retinopathy is due to ophthalmologist and endocrinologist responsibility . Socio-economic and cultural levels plays a primordial role. including a fight against diabet in public health programs