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

• Published in: British journal of ophthalmology Vol. 91; no. 12; pp. 1599 - 1601
• Main Authors: OLOFSDOTTIR, E, STEFANSSON, E
• Format: Journal Article
• Language: English
• Published: BMA House, Tavistock Square, London, WC1H 9JR BMJ Publishing Group Ltd 01.12.2007; BMJ; BMJ Publishing Group LTD; BMJ Group
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Biological and medical sciences; Cost Control; Diabetes Mellitus, Type 1; Diabetes Mellitus, Type 2; Diabetes. Impaired glucose tolerance; Diabetic Retinopathy - diagnosis; Diabetic Retinopathy - epidemiology; Diabetic Retinopathy - physiopathology; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; Etiopathogenesis. Screening. Investigations. Target tissue resistance; Female; Health Care Costs; Humans; Incidence; Macular Edema - diagnosis; Macular Edema - epidemiology; Male; Mass Screening; Medical sciences; Middle Aged; Miscellaneous; Ophthalmology; Retinopathies; Scientific Report; Time Factors; Visual Acuity; Endocrinopathy; Human; Screening; Eye disease; Retinopathy; Diabetes mellitus; Ophthalmology; Medical screening
• ISSN: 0007-1161; 1468-2079
• DOI: 10.1136/bjo.2007.123810

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.