Tackling diabetic retinopathy from the grassroots

Sivaprasad, Sobha

doi:10.4103/ijo.ijo_2340_19

Cited by 2 publications

(3 citation statements)

References 12 publications

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“…In order to provide access to a DR care pathway to all who need it and reduce health inequality, there is an urgent need to upskill the health workforce in India, as well as, train additional health professionals, strengthen data quality, governance and accountability of care models to ensure sustainability and scalability of good practice. A solution to the shortage of ophthalmologists is to urgently train and prepare allied specialities to cross their current boundaries to acquire new strengths, skills and competencies through research, practice, policy and education to diminish the gap between demand to clinical services and workforce deficiency [10].…”

Section: The Global Challenge Of Visual Impairment Due To Sight Threa...mentioning

confidence: 99%

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The ORNATE India Project: United Kingdom–India Research Collaboration to tackle visual impairment due to diabetic retinopathy

Sivaprasad

Raman

Conroy³

et al. 2020

Eye

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Introduction The ORNATE India project is funded by the UK Research and Innovation (UKRI) through the Global Challenges Research Fund. The aim is to build research capacity and capability in India and the UK to tackle global burden of diabetes-related visual impairment. As there are over 77 million people with diabetes in India, it is challenging to screen every person with diabetes annually for sight-threatening diabetic retinopathy (DR). Therefore, alternate safe approaches need to be developed so that those at-risk of visual impairment due to DR is identified promptly and treated. Methods The project team utilised diverse global health strategies and research methods to co-design work packages to build research capacity and capability to ensure effective, affordable and efficient DR services are made available for the population. The strategies and methods employed included health system strengthening; implementation science; establishing care pathways; co-designing collaborative studies on affordable technologies, developing quality standards and guidelines to decrease variations in care; economic analysis; risk modelling and stratification. Five integrated work packages have been developed to deal with all aspects of DR care. These included implementation of a DR screening programme in the public health system in a district in Kerala, evaluating regional prevalence of diabetes and DR and assessing ideal tests for holistic screening for diabetes and its complications in 20 areas in India, utilising artificial intelligence on retinal images to facilitate DR screening, exploring biomarker and biosensor research to detect people at risk of diabetes complications, estimating cost of blindness in India and risk modelling to develop risk-based screening models for diabetes and its complications. A large collaborative network will be formed to propagate research, promote shared learning and bilateral exchanges between high-and middle-income countries to tackle diabetes-related blindness.Members of the ORNATE India Project Group are listed below Acknowledgements.

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Section: The Global Challenge Of Visual Impairment Due To Sight Threa...mentioning

confidence: 99%

“…(9) Can the formation of a DR Clinical Network in India help to guide clinical practice? (10) What aspects of the findings of this project can be translated globally or can be used to model reverse innovation of DR screening in the UK?…”

Section: Aims Of the Ornate India Projectmentioning

confidence: 99%

The ORNATE India Project: United Kingdom–India Research Collaboration to tackle visual impairment due to diabetic retinopathy

Sivaprasad

Raman

Conroy³

et al. 2020

Eye

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“…India would require an estimated 70 million screening appointments every year as a start and increase the capacity exponentially every year to meet the rising numbers of people with diabetes. [ 5 ] Therefore, targeted and opportunistic screening are better options to achieving the optimum performance of DR screening programs. Two strategies could help: one, use fundus photography for DR diagnosis, and two, utilize the services of nonophthalmologist technical personnel for screening and referrals.…”

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confidence: 99%

Training of nonophthalmologists in diabetic retinopathy screening

Rani

Takkar

Das

2021

Indian Journal of Ophthalmology

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The burden of diabetes mellitus (DM) and diabetic retinopathy (DR) is at alarming proportions in India and around the globe. The number of people with DM in India is estimated to increase to over 134 million by 2045. Screening and early identification of sight-threatening DR are proven ways of reducing DR-related blindness. An ideal DR screening model should include personalized awareness, targeted screening, integrated follow-up reminders, and capacity building. The DR screening technology is slowly shifting from direct examination by an ophthalmologist to remote screening using retinal photographs, including telescreening and automated grading of retinal images using artificial intelligence. The ophthalmologist-to-patient ratio is poor in India, and there is an urban–rural divide. The possibility of screening all people with diabetes by ophthalmologists alone is a remote possibility. It is prudent to use the available nonophthalmologist workforce for DR screening in tandem with the technological advances. Capacity-building efforts are based on the principle of task sharing, which allows for the training of a variety of nonophthalmologists in DR screening techniques and technology. The nonophthalmologist human resources for health include physicians, optometrists, allied ophthalmic personnel, nurses, and pharmacists, among others. A concurrent augmentation of health infrastructure, conducive health policy, improved advocacy, and increased people's participation are necessary requirements for successful DR screening. This perspective looks at the characteristics of various nonophthalmologist DR screening models and their applicability in addressing DR-related blindness in India.

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Tackling diabetic retinopathy from the grassroots

Cited by 2 publications

References 12 publications

The ORNATE India Project: United Kingdom–India Research Collaboration to tackle visual impairment due to diabetic retinopathy

The ORNATE India Project: United Kingdom–India Research Collaboration to tackle visual impairment due to diabetic retinopathy

Training of nonophthalmologists in diabetic retinopathy screening

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