Journal of Diabetes Science and Technology 2020
High Frequency of Asteroid Hyalosis Precludes Diabetic Retinopathy Screening With Smartphone-Based Retinal Camera in Brazilian Xavante Indians
Fernando Korn Malerbi, Amaury Lelis Dal Fabbro, Regina Celia Santiago Moises, João Paulo Botelho Vieira Filho, and Laercio Joel Franco.
Asteroid hyalosis (AH) is a rare condition in which small, yellow-white spherical particles known as asteroid bodies are present within the vitreous body. Population-based epidemiological and autopsy studies have found a low prevalence of AH, ranging 0.8%-1.2%; association of AH with systemic diseases such as diabetes mellitus (DM) has been proposed but is not well established. Although AH fills the vitreous body with opaque structures, it generally has a minor impact on vision; even in severe cases that render fundus examination impossible, vision is often unaffected. However, its presence may preclude diabetic retinopathy (DR) assessment.
In this setting, ophthalmological examination was offered at two Xavante Reserves in January 2020, primarily for DR screening. Villages were selected due to operational conditions in order to optimize field work. A total of 158 individuals (59.5% with diabetes) underwent retinal photographs with a handheld smartphone-based device (Eyer, Phelcom Technologies, São Carlos, Brazil). In the Sangradouro/Volta Grande Reserve (total estimated adult population: 623), 82 individuals from one vil- lage were examined; in the São Marcos Reserve (total estimated adult population: 1588),3 76 individuals from 6 villages were examined. AH distribution among individuals with and without diabetes was not dif- ferent (chi-square test, P=.417); age (Student's t-test, P=.533) and gender (chi-square test, P=.579) were not different among groups with and without AH either.
Overall, AH was detected in 17 individuals, a 10.7% frequency rate. Five patients had bilateral AH, and 12 had DM (70.6%); AH distribution among individuals with and without diabetes was not different (chi-square test, P=.417); age (Student's t-test, P=.533) and gender (chi-square test, P=.579) were not different among groups with and without AH either. Interestingly, many of the individuals with AH were clearly family related (Figure 1). The finding of an abnormally high frequency of AH in this population, in which every village may correspond to one or some extended family units, and its 'cluster' distribution in limited geographic areas point to a familial component of inheritance.
High Frequency of Asteroid Hyalosis Precludes Diabetic Retinopathy Screening With Smartphone-Based Retinal Camera in Brazilian Xavante Indians High Frequency of Asteroid Hyalosis Precludes Diabetic Retinopathy Screening With Smartphone-Based Retinal Camera in Brazilian Xavante Indians