Two-field mydriatic fundus photography to assess the prevalence of macular disorder in diabetes

T.A. Avanesova^1,2, J.G. Oganezova^3,4, V.V. Anisimova⁵, A.B. Baeva^3,6, D.H. Miaev¹ ¹LLC "Liga+”, Reutov, Russian Federation ²LLC "Eye Microsurgery Center of Moscow Region", Sergiev Posad, Russian Federation ³Pirogov Russian National Research Medical University, Moscow, Russian Federation ⁴Research Center for Medical Genetics, Moscow, Russian Federation ⁵Central Clinical Hospital and Polyclinic of the Department for Presidential Affairs,&nbsp;&nbsp; Moscow, Russian Federation ⁶Hospital for War Veterans No. 2, Moscow, Russian Federation <b>Aim:</b> to evaluate the prevalence of macular dysfunction in patients with type 1 (T1D) and type 2 diabetes (T2D) of different age and sex based on fundus photographs. <b>Materials and Methods:</b> this work is part of a study involving medical institutions of five cities of the Russian Federation. 367 patients with diabetes (34.88% males and 65.12% females; mean age 50.88±20.55 years) were enrolled, including 34.88% with T1D and 65.12% with T2D. The mean disease duration was 9.02±7.22 years. 58.31% of the patients had a history of hypertension and 13.08% a history of smoking. The ophthalmologists evaluated two-field fundus photographs and graded the changes as M0 (no diabetic changes in the macula) or M1 (diabetic changes in the macula). Non-diabetic changes were not included in the analysis. The presence of exudates, microaneurysms or hemorrhages within 1 DD from the center of the fovea, circular or clustered exudates in the macular area were evaluated. <b>Results: </b>diabetic maculopathy (DM) was found in 47 (12.81%) patients. DM was associated with diabetic retinopathy (DR) in 18 (4.90%) patients. DM was mainly observed in patients with T2D (15.90%), in women (8.45%) and bilaterally (8.17%). There were no significant differences in visual acuity between patients with and without diabetes. There was a trend towards an increased prevalence of DM in older patients with a history of T2D of 15–25 years (p&gt;0.05). No significant differences were found in the incidence of DM and DM+DR according to glycated hemoglobin (HbA1c) levels. DM developed in 11.11% of patients with HbA1c≤7.5% and in 15.79% of patients with HbA1c&gt;7.5% (p=0.260). There was a trend towards an increased prevalence of DM in smokers (20.83% vs. 11.60% in non-smokers, p=0.120). Elevated blood pressure did not affect the incidence of DM. <b>Conclusion: </b>these findings (some of which were presented in the previous publication and will be presented in the next one) emphasize the efficacy of two-field mydriatic fundus photography as a screening tool for diabetic retinopathy and maculopathy. <b>Keywords: </b>diabetes, retina, diabetic maculopathy, diabetic retinopathy, diabetic macular edema, screening, fundus photography, prevalence, two-field photography, risk groups. <b>For citation: </b>Avanesova T.A., Oganezova J.G., Anisimova V.V., Baeva A.B., Miaev D.H. Two-field mydriatic fundus photography to assess the prevalence of macular disorder in diabetes. Russian Journal of Clinical Ophthalmology. 2024;24(3):102–108 (in Russ.). DOI: 10.32364/2311-7729-2024-24-3-1.