Progression of diabetes retinal status within community screening programs and potential implications for screening intervals

Four Nations Diabetic Retinopathy Screening Study Group

doi:10.2337/dc14-1778

Progression of diabetes retinal status within community screening programs and potential implications for screening intervals

Four Nations Diabetic Retinopathy Screening Study Group

Health Sciences

Research output: Contribution to journal › Article › peer-review

Abstract

OBJECTIVE: This study aimed to follow the natural progression of retinal changes in patients with diabetes. Such information should inform decisions with regard to the screening intervals for such patients.

RESEARCH DESIGN AND METHODS: An observational study was undertaken linking the data from seven diabetes retinal screening programs across the U.K. for retinal grading results between 2005 and 2012. Patients with absent or background retinopathy were followed up for progression to the end points referable retinopathy and treatable retinopathy (proliferative retinopathy).

RESULTS: In total, 354,549 patients were observed for up to 4 years during which 16,196 patients progressed to referable retinopathy. Of patients with no retinopathy in either eye for two successive screening episodes at least 12 months apart, the conditions of between 0.3% (95% CI 0.3-0.8%) and 1.3% (1.0-1.6%) of patients progressed to referable retinopathy, and rates of treatable eye disease were <0.3% at 2 years. The corresponding progression rates for patients with bilateral background retinopathy in successive screening episodes were 13-29% and up to 4%, respectively, in the different programs.

CONCLUSIONS: It may be possible to stratify patients for risk, according to baseline retinal criteria, into groups with low and high risk of their conditions progressing to proliferative retinopathy. Screening intervals for such diverse groups of patients could safely be modified according to their risk.

Original language	English
Pages (from-to)	488-94
Number of pages	7
Journal	Diabetes Care
Volume	38
Issue number	3
Early online date	18 Dec 2014
DOIs	https://doi.org/10.2337/dc14-1778
Publication status	Published - 24 Feb 2015

Bibliographical note

Keywords

Adult
Diabetes Mellitus, Type 2/complications
Diabetic Retinopathy/diagnosis
Disease Progression
Female
Humans
Male
Mass Screening/methods
Middle Aged
Retina/pathology
Retinal Diseases/diagnosis
Retrospective Studies
Time Factors

Access to Document

10.2337/dc14-1778

Cite this

@article{cdc68c2895dc4f179c91270dae2a51b2,

title = "Progression of diabetes retinal status within community screening programs and potential implications for screening intervals",

abstract = "OBJECTIVE: This study aimed to follow the natural progression of retinal changes in patients with diabetes. Such information should inform decisions with regard to the screening intervals for such patients.RESEARCH DESIGN AND METHODS: An observational study was undertaken linking the data from seven diabetes retinal screening programs across the U.K. for retinal grading results between 2005 and 2012. Patients with absent or background retinopathy were followed up for progression to the end points referable retinopathy and treatable retinopathy (proliferative retinopathy).RESULTS: In total, 354,549 patients were observed for up to 4 years during which 16,196 patients progressed to referable retinopathy. Of patients with no retinopathy in either eye for two successive screening episodes at least 12 months apart, the conditions of between 0.3% (95% CI 0.3-0.8%) and 1.3% (1.0-1.6%) of patients progressed to referable retinopathy, and rates of treatable eye disease were <0.3% at 2 years. The corresponding progression rates for patients with bilateral background retinopathy in successive screening episodes were 13-29% and up to 4%, respectively, in the different programs.CONCLUSIONS: It may be possible to stratify patients for risk, according to baseline retinal criteria, into groups with low and high risk of their conditions progressing to proliferative retinopathy. Screening intervals for such diverse groups of patients could safely be modified according to their risk.",

keywords = "Adult, Diabetes Mellitus, Type 2/complications, Diabetic Retinopathy/diagnosis, Disease Progression, Female, Humans, Male, Mass Screening/methods, Middle Aged, Retina/pathology, Retinal Diseases/diagnosis, Retrospective Studies, Time Factors",

author = "{Four Nations Diabetic Retinopathy Screening Study Group} and Leese, {Graham P} and Stratton, {Irene M} and Martin Land and Bachmann, {Max O} and Colin Jones and Peter Scanlon and Looker, {Helen C} and Brian Ferguson",

note = "{\textcopyright} 2015 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered.",

year = "2015",

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doi = "10.2337/dc14-1778",

language = "English",

volume = "38",

pages = "488--94",

journal = "Diabetes Care",

issn = "0149-5992",

publisher = "American Diabetes Association Inc.",

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T1 - Progression of diabetes retinal status within community screening programs and potential implications for screening intervals

AU - Four Nations Diabetic Retinopathy Screening Study Group

AU - Leese, Graham P

AU - Stratton, Irene M

AU - Land, Martin

AU - Bachmann, Max O

AU - Jones, Colin

AU - Scanlon, Peter

AU - Looker, Helen C

AU - Ferguson, Brian

PY - 2015/2/24

Y1 - 2015/2/24

N2 - OBJECTIVE: This study aimed to follow the natural progression of retinal changes in patients with diabetes. Such information should inform decisions with regard to the screening intervals for such patients.RESEARCH DESIGN AND METHODS: An observational study was undertaken linking the data from seven diabetes retinal screening programs across the U.K. for retinal grading results between 2005 and 2012. Patients with absent or background retinopathy were followed up for progression to the end points referable retinopathy and treatable retinopathy (proliferative retinopathy).RESULTS: In total, 354,549 patients were observed for up to 4 years during which 16,196 patients progressed to referable retinopathy. Of patients with no retinopathy in either eye for two successive screening episodes at least 12 months apart, the conditions of between 0.3% (95% CI 0.3-0.8%) and 1.3% (1.0-1.6%) of patients progressed to referable retinopathy, and rates of treatable eye disease were <0.3% at 2 years. The corresponding progression rates for patients with bilateral background retinopathy in successive screening episodes were 13-29% and up to 4%, respectively, in the different programs.CONCLUSIONS: It may be possible to stratify patients for risk, according to baseline retinal criteria, into groups with low and high risk of their conditions progressing to proliferative retinopathy. Screening intervals for such diverse groups of patients could safely be modified according to their risk.

AB - OBJECTIVE: This study aimed to follow the natural progression of retinal changes in patients with diabetes. Such information should inform decisions with regard to the screening intervals for such patients.RESEARCH DESIGN AND METHODS: An observational study was undertaken linking the data from seven diabetes retinal screening programs across the U.K. for retinal grading results between 2005 and 2012. Patients with absent or background retinopathy were followed up for progression to the end points referable retinopathy and treatable retinopathy (proliferative retinopathy).RESULTS: In total, 354,549 patients were observed for up to 4 years during which 16,196 patients progressed to referable retinopathy. Of patients with no retinopathy in either eye for two successive screening episodes at least 12 months apart, the conditions of between 0.3% (95% CI 0.3-0.8%) and 1.3% (1.0-1.6%) of patients progressed to referable retinopathy, and rates of treatable eye disease were <0.3% at 2 years. The corresponding progression rates for patients with bilateral background retinopathy in successive screening episodes were 13-29% and up to 4%, respectively, in the different programs.CONCLUSIONS: It may be possible to stratify patients for risk, according to baseline retinal criteria, into groups with low and high risk of their conditions progressing to proliferative retinopathy. Screening intervals for such diverse groups of patients could safely be modified according to their risk.

KW - Adult

KW - Diabetes Mellitus, Type 2/complications

KW - Diabetic Retinopathy/diagnosis

KW - Disease Progression

KW - Female

KW - Humans

KW - Male

KW - Mass Screening/methods

KW - Middle Aged

KW - Retina/pathology

KW - Retinal Diseases/diagnosis

KW - Retrospective Studies

KW - Time Factors

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DO - 10.2337/dc14-1778

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C2 - 25524948

SN - 0149-5992

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SP - 488

EP - 494

JO - Diabetes Care

JF - Diabetes Care

IS - 3

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