Non-attendance at diabetic eye screening and risk of sight-threatening diabetic retinopathy: a population-based cohort study

Abstract

Aims/hypothesis This study evaluated whether repeated nonattendance for diabetic eye screening is associated with the risk of sight-threatening diabetic retinopathy (STDR). Methods This was a cohort study of 6,556 residents with diabetes who were invited for screening between 2008 and 2011 in a population-based eye screening programme in inner London and who attended for their first-ever screen in 2008. The proportion of participants with STDR was evaluated in relation to the number of years in which screening was missed.Results The proportion of participants who did not attend screening decreased between 2009 and 2011 (annual reduction 1.6% [95% CI 0.9%, 2.3%]). The adjusted relative odds of STDR for 210 participants who did not attend two consecutive years of screening were 3.76 (95% CI 2.14, 6.61; p<0.001), compared with participants who were screened annually. In 605 participants with mild non-proliferative retinopathy at the first screen, the adjusted relative odds of developing proliferative or moderate to severe nonproliferative retinopathy were 5.72 (95% CI 7.43, 22.83; p=0.013) for 53 participants who missed two screens. Conclusions/interpretation Patients who do not attend diabetic eye screening are at increased risk of developing STDR. Tracing of non-attenders with evidence of established retinopathy should be an important fail-safe procedure.

Prevalence of diabetic retinopathy in screening-detected diabetes mellitus: results from the Gutenberg Health Study (GHS)

“…Therefore, screening for diabetes may lead to the detection of retinopathy at an earlier stage before clinically evident complications occur. In line with this, it has been shown that patients who do not attend diabetic eye screenings are at increased risk of developing sight-threatening diabetic retinopathy [12].…”

Diabetic retinopathy in a remote Indigenous primary healthcare population: a Central Australian diabetic retinopathy screening study in the Telehealth Eye and Associated Medical Services Network project

“…Diabetic retinopathy (DR) is a major cause of vision loss, globally , and disproportionately affects vulnerable populations, such as those in low‐income countries and Indigenous populations . DR screening has been widely promoted for decades; however, adherence to recommendations remains suboptimal, particularly among those at higher risk of DR and vision loss .…”

Optimizing Medical Management in Patients with Sight-Threatening Diabetic Retinopathy

“…Failure to attend outpatient appointments is a particularly prevalent issue in the diabetic population and is associated with poorer outcomes [38, 39]. Of the 54 patients referred by our eye department to the diabetic retinopathy clinic, 22 failed to attend their initial clinic appointment.…”