Fundamental principles of an effective diabetic retinopathy screening program

Lanzetta, Paolo, Sarao, Valentina, Scanlon, Peter H ORCID: 0000-0001-8513-710X, Barratt, Jane, Porta, Massimo, Bandello, Francesco, Loewenstein, Anat, Eldem, Bora, Hunyor, Alex, Joussen, Antonia, Koh, Adrian, Korobelnik, Jean-François, Lanzetta, Paolo, Loewenstein, Anat, Lövestam-Adrian, Monica, Navarro, Rafael, Okada, Annabelle A., Pearce, Ian, Rodríguez, Francisco J., Staurenghi, Giovanni, Wolf, Sebastian and Wong, David T. (2020) Fundamental principles of an effective diabetic retinopathy screening program. Acta Diabetologica, 57. pp. 785-798. doi:10.1007/s00592-020-01506-8

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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.

Item Type: Article
Article Type: Article
Uncontrolled Keywords: Diabetic retinopathy screening; Evidence-based recommendations; Telemedicine
Related URLs:
Subjects: R Medicine > RA Public aspects of medicine > RA645.A-Z Individual diseases or groups of diseases, A-Z > RA645.D54 Diabetes
R Medicine > RE Ophthalmology
Research Priority Areas: Sport, Exercise, Health & Wellbeing
Depositing User: Susan Turner
Date Deposited: 03 Apr 2020 15:06
Last Modified: 03 Sep 2020 16:00
URI: http://eprints.glos.ac.uk/id/eprint/8283

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