Fundamental principles of an effective diabetic retinopathy screening program
- PMID: 32222818
- PMCID: PMC7311555
- DOI: 10.1007/s00592-020-01506-8
Fundamental principles of an effective diabetic retinopathy screening program
Erratum in
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Correction to: Fundamental principles of an effective diabetic retinopathy screening program.Acta Diabetol. 2020 Jul;57(7):907-908. doi: 10.1007/s00592-020-01541-5. Acta Diabetol. 2020. PMID: 32419091 Free PMC article.
Abstract
Background: Diabetic retinopathy (DR) is the leading cause of blindness among working-age adults worldwide. Early detection and treatment are necessary to forestall vision loss from DR.
Methods: A working group of ophthalmic and diabetes experts was established to develop a consensus on the key principles of an effective DR screening program. Recommendations are based on analysis of a structured literature review.
Results: The recommendations for implementing an effective DR screening program are: (1) Examination methods must be suitable for the screening region, and DR classification/grading systems must be systematic and uniformly applied. Two-field retinal imaging is sufficient for DR screening and is preferable to seven-field imaging, and referable DR should be well defined and reliably identifiable by qualified screening staff; (2) in many countries/regions, screening can and should take place outside the ophthalmology clinic; (3) screening staff should be accredited and show evidence of ongoing training; (4) screening programs should adhere to relevant national quality assurance standards; (5) studies that use uniform definitions of risk to determine optimum risk-based screening intervals are required; (6) technology infrastructure should be in place to ensure that high-quality images can be stored securely to protect patient information; (7) although screening for diabetic macular edema (DME) in conjunction with DR evaluations may have merit, there is currently insufficient evidence to support implementation of programs solely for DME screening.
Conclusion: Use of these recommendations may yield more effective DR screening programs that reduce the risk of vision loss worldwide.
Keywords: Diabetic retinopathy screening; Evidence-based recommendations; Telemedicine.
Conflict of interest statement
Paolo Lanzetta has received honoraria for speaking at symposia; financial support for attending symposia; financial support for educational programs; and consultation fees from Bayer, Centervue and Novartis. Valentina Sarao has no potential conflicts of interest to declare. Peter H. Scanlon has received advisory board or speaker fees from Allergan, Bayer, Boehringer Ingelheim, Pfizer, Roche and Novartis; and support for attending meetings from Bayer. His institution has received educational research or audit grants from Allergan, Bayer, Boehringer Ingelheim, Novartis and Pfizer. Jane Barratt has no potential conflicts of interest to declare. Massimo Porta has received advisory board and speaker fees from Allergan, Novartis and SIFI. Francesco Bandello has received consultancy fees from Allergan, Bayer, Boehringer Ingelheim, Fidia, Hoffmann La Roche, Novartis, NTC Pharma, SIFI, Thrombogenics and Zeiss. Anat Loewenstein has received consultancy fees or advisory board fees from Allergan, Alcon, Bayer, Beyeonics Surgical, Neutech, Notal Vision, Novartis, Roche and Syneos Health. Her institution has received research grants/support from Allergan, Bayer, Sensor and Novartis.
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References
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