Progression of Diabetes Retinal Status Within Community Screening Programs and Potential Implications for Screening Intervals

Leese, Graham; Stratton, I M; Land, Martin; Bachmann, Max; Jones, Colin; Scanlon, Peter H; Looker, Helen C.; Ferguson, Brian

doi:10.2337/dc14-1778

Cited by 46 publications

(64 citation statements)

References 24 publications

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“…The inclusion criteria for this Four Nations data set have been reported in a previous publication 3. The four English programmes were chosen to cover urban and rural areas, high and low levels of socio‐economic deprivation and to include programmes with sizeable ethnic minority populations.…”

Section: Methodsmentioning

confidence: 99%

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Screening attendance, age group and diabetic retinopathy level at first screen

Scanlon¹,

Stratton²,

Leese

et al. 2015

Diabet. Med.

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AimsTo report on the relationships between age at diagnosis of diabetes, time from registration with the screening programme to first diabetic eye screening and severity of diabetic retinopathy.MethodsData were extracted from four English screening programmes and from the Scottish, Welsh and Northern Irish programmes. Time from diagnosis of diabetes to first screening and age at diagnosis were calculated.ResultsTime from registration with the screening programme to first screening episode is strongly related to age at registration. Within 18 months of registration 89% of 3958 young people under 18 years of age and 81% of 391 293 people over 35 years of age were seen. In 19 058 people between 18 and 34 years of age, 80% coverage was not reached until 2 years and 9 months. The time from diagnosis of diabetes to first screening is positively associated with severity of disease (P < 0.0001).ConclusionsThis report is the first that to demonstrate that those in the 18–34 year age group are least likely to attend promptly for screening after registration with a higher risk of referable diabetic retinopathy being present at the time of first screen. Date of diagnosis should be recorded and prodigious efforts made to screen all people promptly after diagnosis. Screening programmes should collect data on those who have not attended within one year of registration.

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Section: Methodsmentioning

confidence: 99%

“…Data sets were obtained from Scotland, Wales, Northern Ireland and from four English screening programmes to examine the performance of an algorithm to estimate risk 2 and a recent report on this has been published 3.…”

Section: Introductionmentioning

confidence: 99%

Screening attendance, age group and diabetic retinopathy level at first screen

Scanlon¹,

Stratton²,

Leese

et al. 2015

Diabet. Med.

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show abstract

“…We recruited data for the Four Nations study from seven diabetic retinopathy screening programmes: the whole‐nation programmes in Wales, Scotland and Northern Ireland and four local English programmes (Brighton, Derbyshire, Leeds and Staffordshire). For the present study, one English programme was excluded because no data were available for age at diagnosis of diabetes.…”

Section: Methodsmentioning

confidence: 99%

Risk of diabetic retinopathy at first screen in children at 12 and 13 years of age

Scanlon¹,

Stratton

Bachmann³

et al. 2016

Diabet. Med.

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AimsTo investigate the relationships between age at diagnosis of diabetes, age at diabetic eye screening and severity of diabetic retinopathy at first and subsequent screenings in children aged 12 or 13 years.MethodsData were extracted from four English screening programmes and from the Scottish, Welsh and Northern Irish programmes on all children with diabetes invited for their first and subsequent screening episodes from the age of 12 years. Retinopathy levels at first and subsequent screens, time from diagnosis of diabetes to first screening and age at diagnosis in years were calculated.ResultsData were available for 2125 children with diabetes screened for the first time at age 12 or 13 years. In those diagnosed with diabetes at 2 years of age or less, the proportion with retinopathy in one or both eyes was 20% and 11%, respectively, decreasing to 8% and 2% in those diagnosed between 2 and 12 years (P < 0.0001). Only three children (aged 8, 10 and 11 years at diagnosis of diabetes) had images graded with referable retinopathy and, of these, two had non‐referable diabetic retinopathy at all subsequent screenings. Of 1703 children with subsequent images, 25 were graded with referable diabetic retinopathy over a mean follow‐up of 3.1 years, an incidence rate of 4.7 (95% confidence interval, 3.1–7.0) per 1000 per year.ConclusionsIn this large cohort of children, the low prevalence and incidence rates of referable diabetic retinopathy suggest that screening earlier than age 12 is not necessary.

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“…Furthermore, as the electronic medical record becomes more universally integrated within telemedicine programs, evaluation of longitudinal clinical data may provide information relevant to care recommendations that may not otherwise be readily discovered. 8 The retinal imaging device remains a technological cornerstone of any telemedicine program for diabetic retinopathy. Retinal imaging devices must meet current recommendations of image resolution (20 pixels per degree with a resolution of at least 10-15 μm) and must be validated against Early Treatment Diabetic Retinopathy Study standard 7-field photography in determining the ability to identify and determine diabetic retinopathy severity.…”

mentioning

confidence: 99%