Screening for diabetic retinopathy

Kristinsson, Jóhannes Kári; Gudmundsson, Jóhann Ragnar; Stefánsson, Einar; Jónasson, Friðbert; Gíslason, Ingimundur; Þórsson, Árni V.

doi:10.1111/j.1600-0420.1995.tb00329.x

Cited by 34 publications

(38 citation statements)

References 29 publications

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“…This study can be seen as an extension of our earlier studies [10,11], which show that alternate year screening for diabetic eye disease seems to be safe and effective in diabetic patients without retinopathy and, by doing this, the financial savings are substantial. In this study we have gone further and used information technology and available epidemiological studies to standardise the risk and make individual determinations of screening intervals for diabetic eye disease.…”

Section: Discussionmentioning

confidence: 58%

“…In 1993, Kalm and Jonsson [9] proposed variable screening intervals based on risk margins and in 1994 the Icelandic screening programme moved in this direction by lengthening the screening interval to 2 years for diabetic patients without retinopathy [10]. This approach has proven to be safe and effective [11], and has been adopted by many diabetic eyescreening programmes.…”

Section: Introductionmentioning

confidence: 99%

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Individual risk assessment and information technology to optimise screening frequency for diabetic retinopathy

et al. 2011

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Aims/hypothesis The aim of this study was to reduce the frequency of diabetic eye-screening visits, while maintaining safety, by using information technology and individualised risk assessment to determine screening intervals. Methods A mathematical algorithm was created based on epidemiological data on risk factors for diabetic retinopathy.Through a website, www.risk.is, the algorithm receives clinical data, including type and duration of diabetes, HbA 1c or mean blood glucose, blood pressure and the presence and grade of retinopathy. These data are used to calculate risk for sight-threatening retinopathy for each individual's worse eye over time. A risk margin is defined and the algorithm recommends the screening interval for each patient with standardised risk of developing sightthreatening retinopathy (STR) within the screening interval. We set the risk margin so that the same number of patients develop STR within the screening interval with either fixed annual screening or our individualised screening system. The database for diabetic retinopathy at the

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Section: Discussionmentioning

confidence: 58%

Section: Introductionmentioning

confidence: 99%

Individual risk assessment and information technology to optimise screening frequency for diabetic retinopathy

et al. 2011

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“…In a previous report on the same group, we found a 2-year incidence of any retinopathy of 23% (Kristinsson et al 1995). Our 4-year incidence of any retinopathy is significantly lower than in the Wisconsin 4-year incidence study (Klein et al 1989a), where the incidence of any retinopathy in type 1 diabetics was 59.0% (160 out of 271) ( Table 3).…”

Section: Retinopathymentioning

confidence: 77%

Active prevention in diabetic eye disease

Kristinsson

Hauksdóttir

Stefánsson

et al. 1997

Acta Ophthalmologica Scandinavica

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ABSTRACT. Ten years after the foundation of a national diabetic eye screening program in 1980, we have established a low prevalence of blindness and partial sight in type 1 and type 2 diabetics in Iceland. We ask whether the screening program is also associated with a low incidence of blindness in diabetics. We now report the results of a prospective study on the 4-year incidence of diabetic retinopathy and visual impairment in type 1 diabetics with age at onset less than 30 years. Out of 205 patients participating at baseline, 175 patients (85.4%) participated over the full 4-year period. Patients were examined annually and received laser treatment according to Diabetic-and Early Treatment Diabetic Retinopathy Study criteria. The 4-year incidence of any retinopathy was 38.1' 36, of proliferative retinopathy 6.694 and of macular edema 3.4%. Out of 174 patients, 7.4% showed improvement in visual acuity of 2 Snellen lines while 2.5% experienced worsening of visual acuity of 2 Snellen lines during the 4-year period. No diabetic suffered more than 2 lines deterioration of vision and none became legally blind. The incidence of retinopathy in Icelandic type 1 diabetics participating in our annual eye screening program is low and the visual acuity stable. Our results suggest that visual impairment in diabetics can be prevented with active regular screening and standard laser therapy.

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“…A review of the first 10 years of diabetic screening in Iceland between 1980 and 1990 revealed that no patient had progressed from no retinopathy to sight-threatening retinopathy in less than 2 years 6. We concluded, and reported, that it was adequate to examine patients with diabetes without retinopathy every other year and immediately introduced this routine into our screening system.…”

mentioning

confidence: 86%

Biennial eye screening in patients with diabetes without retinopathy: 10-year experience

Ólafsdóttir

Stefánsson

2007

British Journal of Ophthalmology

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Aims: To evaluate the safety of every-other-year eye screening for patients with diabetes without retinopathy. Methods: Since 1994, patients with diabetes without retinopathy in Iceland have received eye screening every other year. 296 patients with diabetes who had no diabetic retinopathy in 1994/95 were followed with biennial eye examinations until they had developed retinopathy. The 10-year experience of this approach is reviewed. Results: Out of the 296 diabetic individuals, 172 did not develop diabetic retinopathy during the 10-year observation period. 96 patients developed mild non-proliferative retinopathy, six developed clinically significant diabetic macular oedema, 23 developed preproliferative retinopathy, and four developed proliferative diabetic retinopathy during the 10-year observation period. All the patients who developed macular oedema or proliferative retinopathy had already been diagnosed as having mild nonproliferative retinopathy and entered an annual screening protocol before the sight-threatening retinopathy developed. No patient had any undue delay in treatment. Conclusion: Every other year screening for diabetic eye disease seems to be safe and effective in diabetics without retinopathy. Such an approach will reduce the number of screening visits more than 25%. This reduces health costs and strain on resources considerably and relieves the patients with diabetes from unnecessary clinic visits and examinations.

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Screening for diabetic retinopathy

Cited by 34 publications

References 29 publications

Individual risk assessment and information technology to optimise screening frequency for diabetic retinopathy

Individual risk assessment and information technology to optimise screening frequency for diabetic retinopathy

Active prevention in diabetic eye disease

Biennial eye screening in patients with diabetes without retinopathy: 10-year experience

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