A systematic review of diabetic retinopathy screening intervals

Abstract

The current evidence on whether annual diabetic retinopathy (DR) screening intervals can be extended was reviewed. A systematic review protocol was followed (PROSPERO ID: CRD42022359590). Original longitudinal articles that specifically assessed DR screening intervals were in English and collected data after 2000 were included. Two reviewers independently conducted the search and reviewed the articles for quality and relevant information. The heterogeneity of the data meant that a meta‐analysis was not appropriate. Twelve publications were included. Studies were of good quality and many used data from DR screening programs. Studies fit into three categories; those that assessed specific DR screening intervals, those that determined optimal DR screening intervals and those that developed/assessed DR screening risk equations. For those with type 2 diabetes, extending screening intervals to 3‐ to 4‐yearly in those with no baseline DR appeared safe. DR risk equations considered clinical factors and allocated those at lower risk of DR progression screening intervals of up to five years. Those with baseline DR or type 1 diabetes appeared to have a higher risk of progression to STDR and needed more frequent screening. DR screening intervals can be extended to 3–5 yearly in certain circumstances. These include patients with type 2 diabetes and no current DR, and those who have optimal management of other risk factors such as glucose and blood pressure.

Referable Diabetic Retinopathy Prediction Algorithm Applied to a Population of 120,389 Type 2 Diabetics over 11 Years Follow-Up

“…Likewise, different entities have recommended extending the control period from one to two years for patients with well-managed DM, but what this looks like has not been defined. A recently published systematic review article [9] evaluated a total of 11 relevant studies, in which the interval between visits ranged between 2 and 5 years. However, only three of them used a DR prediction algorithm [10][11][12], that developed by Aspelund et al [13].…”

UNDERSTANDING DIABETIC RETINOPATHY SCREENING ATTENDANCE AMONG PEOPLE WITH TYPE 2 DIABETES: The what, why, and how

“…The idea of personalizing and extending intervals has been entertained since the start of this century and has gained increasing traction in recent years. This is partially due to accumulating evidence suggesting that biennial and even longer intervals may be safe for most patients with diabetes [8,[90][91][92][93][94]. In fact, the Danish national guideline states that the screening interval can be extended by up to 4 years for those with well-regulated diabetes who have not previously had diabetic retinopathy [83,85].…”