Graham P Leese1, Irene M Stratton2, Martin Land3, Max O Bachmann4, Colin Jones5, Peter Scanlon2, Helen C Looker6, Brian Ferguson7. 1. Ninewells Hospital and Medical School, Dundee, U.K. grahamleese@nhs.net. 2. Gloucestershire Eye Unit, Gloucester, U.K. 3. Landmark Health Consulting, York, U.K. 4. Norwich Medical School, Norwich, U.K. 5. Norwich and Norfolk University Hospital, Norwich, U.K. 6. University of Dundee, Dundee, U.K. 7. Public Health England, London, U.K.
Abstract
OBJECTIVE: This study aimed to follow the natural progression of retinal changes in patients with diabetes. Such information should inform decisions with regard to the screening intervals for such patients. RESEARCH DESIGN AND METHODS: An observational study was undertaken linking the data from seven diabetes retinal screening programs across the U.K. for retinal grading results between 2005 and 2012. Patients with absent or background retinopathy were followed up for progression to the end points referable retinopathy and treatable retinopathy (proliferative retinopathy). RESULTS: In total, 354,549 patients were observed for up to 4 years during which 16,196 patients progressed to referable retinopathy. Of patients with no retinopathy in either eye for two successive screening episodes at least 12 months apart, the conditions of between 0.3% (95% CI 0.3-0.8%) and 1.3% (1.0-1.6%) of patients progressed to referable retinopathy, and rates of treatable eye disease were <0.3% at 2 years. The corresponding progression rates for patients with bilateral background retinopathy in successive screening episodes were 13-29% and up to 4%, respectively, in the different programs. CONCLUSIONS: It may be possible to stratify patients for risk, according to baseline retinal criteria, into groups with low and high risk of their conditions progressing to proliferative retinopathy. Screening intervals for such diverse groups of patients could safely be modified according to their risk.
OBJECTIVE: This study aimed to follow the natural progression of retinal changes in patients with diabetes. Such information should inform decisions with regard to the screening intervals for such patients. RESEARCH DESIGN AND METHODS: An observational study was undertaken linking the data from seven diabetes retinal screening programs across the U.K. for retinal grading results between 2005 and 2012. Patients with absent or background retinopathy were followed up for progression to the end points referable retinopathy and treatable retinopathy (proliferative retinopathy). RESULTS: In total, 354,549 patients were observed for up to 4 years during which 16,196 patients progressed to referable retinopathy. Of patients with no retinopathy in either eye for two successive screening episodes at least 12 months apart, the conditions of between 0.3% (95% CI 0.3-0.8%) and 1.3% (1.0-1.6%) of patients progressed to referable retinopathy, and rates of treatable eye disease were <0.3% at 2 years. The corresponding progression rates for patients with bilateral background retinopathy in successive screening episodes were 13-29% and up to 4%, respectively, in the different programs. CONCLUSIONS: It may be possible to stratify patients for risk, according to baseline retinal criteria, into groups with low and high risk of their conditions progressing to proliferative retinopathy. Screening intervals for such diverse groups of patients could safely be modified according to their risk.
Authors: Rebecca L Thomas; Thomas G Winfield; Matthew Prettyjohns; Frank D Dunstan; Wai-Yee Cheung; Philippa M Anderson; Rajesh Peter; Stephen D Luzio; David R Owens Journal: Eur J Health Econ Date: 2020-05-08
Authors: Dawn A Sim; Danny Mitry; Philip Alexander; Adam Mapani; Srini Goverdhan; Tariq Aslam; Adnan Tufail; Catherine A Egan; Pearse A Keane Journal: J Diabetes Sci Technol Date: 2016-02-01
Authors: Lutfiah Al Turk; Su Wang; Paul Krause; James Wawrzynski; George M Saleh; Hend Alsawadi; Abdulrahman Zaid Alshamrani; Tunde Peto; Andrew Bastawrous; Jingren Li; Hongying Lilian Tang Journal: Transl Vis Sci Technol Date: 2020-08-07 Impact factor: 3.283