Progression of pre-proliferative to proliferative diabetic retinopathy: a 3-year study in the Oxford population-based diabetic retinopathy screening programme

2014 ◽  
Vol 31 (8) ◽  
pp. 1018-1019 ◽  
Author(s):  
M. M. K Muqit ◽  
Y. Yang ◽  
H. Lipinski ◽  
V. Chong
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Andreia Marisa Penso Pereira ◽  
Raul Manuel da Silva Laureano ◽  
Fernando Buarque de Lima Neto

Abstract Background The implementation of a population-based screening programme for diabetic retinopathy involves several challenges, often leading to postponements and setbacks at high human and material costs. Thus, it is of the utmost importance to promote the sharing of experiences, successes, and difficulties. However, factors such as the existence of regional programmes, specificities of each country’s health systems, organisational and even linguistic barriers, make it difficult to create a solid framework that can be used as a basis for future projects. Methods Web of Science and PubMed platforms were searched using appropriate key words. The review process resulted in 423 articles adherent to the search criteria, 28 of which were accepted and analysed. Web sites of all Portuguese governmental and non-governmental organisations, with a relevant role on the research topic, were inspected and 75 official documents were retrieved and analysed. Results Since 2001, five regional screening programmes were gradually implemented under the guidelines of Portuguese General Health Department. However, complete population coverage was still not achieved. Among the main difficulties reported are the complex articulation between different levels of care providers, the low number of orthoptic technician in the national health system, the high burden that images grading, and treatment of positive cases represents for hospitals ophthalmology services, and low adherence rates. Yet, the comparison between strategies adopted in the different regions allowed the identification of potential solutions: hire orthoptic technician for primary health care units, eliminating the dependence of hospital professionals; use artificial intelligence algorithms for automatic retinographies grading, avoiding ophthalmologists overload; adoption of proximity strategies, as the use of portable retinographers, to promote adherence to screening. Conclusion Access to diabetic retinopathy screening remains remarkably variable in Portugal and needs urgent attention. However, several characteristics of effective screening programmes were found in Portuguese screening programmes, what seems to point toward promising outcomes, especially if each other highlights are considered. The findings of this research could be very useful for the other countries with similar socio-political characteristics. Trial registration PROSPERO registration ID CRD42020200115.


2016 ◽  
Vol 11 (1) ◽  
pp. 135-137 ◽  
Author(s):  
Jorge Cuadros ◽  
George Bresnick

Organizations that care for people with diabetes have increasingly adopted telemedicine-based diabetic retinopathy screening (TMDRS) as a way to increase adherence to recommended retinal exams. Recently, handheld retinal cameras have emerged as a low-cost, lightweight alternative to traditional bulky tabletop retinal cameras. Few published clinical trials have been performed on handheld retinal cameras. Peer-reviewed articles about commercially available handheld retinal cameras have concluded that they are a usable alternative for TMDRS, however, the clinical results presented in these articles do not meet criteria published by the United Kingdom Diabetic Eye Screening Programme and the American Academy of Ophthalmology. The future will likely remedy the shortcomings of currently available handheld retinal cameras, and will create more opportunities for preventing diabetic blindness.


2021 ◽  
Author(s):  
Andreia Marisa Penso Pereira ◽  
Raul Manuel Silva Laureano ◽  
Fernando Buarque Lima Neto

Abstract Background: The implementation of a population-based screening programme for diabetic retinopathy involves several challenges, often leading to postponements and setbacks at high human and material costs. Thus, it is of the utmost importance to promote the sharing of experiences, successes and difficulties. However, factors such as the existence of regional programmes, specificities of each country's health systems, organizational and even linguistic barriers, make it difficult to create a solid framework that can be used as a basis for future projects. Methods: Web of Science and PubMed platforms were searched using appropriate key words. The review process resulted in 423 articles adherent to the search criteria, 28 of which were accepted and analysed. Web sites of all Portuguese governmental and non-governmental organizations, with a relevant role on the research topic, were inspected and 75 official documents were retrieved and analysed.Results: Since 2001, five regional screening programmes were gradually implemented under the guidelines of Portuguese General Health Department. However, complete population coverage was still not achieved. Among the main difficulties reported are the complex articulation between different levels of care providers, the low number of orthoptic technician in the national health system, the high burden that images grading and treatment of positive cases represents for hospitals ophthalmology services, and low adherence rates. Yet, the comparison between strategies adopted in the different regions allowed the identification of potential solutions: hire orthoptic technician for primary health care units, eliminating the dependence of hospital professionals; use artificial intelligence algorithms for automatic retinographies grading, avoiding ophthalmologists overload; adoption of proximity strategies, as the use of portable retinographers, to promote adherence to screening.Conclusion: Access to diabetic retinopathy screening remains remarkably variable in Portugal and needs urgent attention. However, several characteristics of effective screening programmes were found in Portuguese screening programmes, what seems to point toward promising outcomes, especially if each other highlights are considered. The findings of this research could be very useful for the other countries with similar socio-political characteristics.Registration: PROSPERO registration ID CRD42020200115.


2021 ◽  
Author(s):  
Andreia Marisa Penso Pereira ◽  
Raul Manuel da Silva Laureano ◽  
Fernando Buarque de Lima Neto

Abstract Background: The implementation of a population-based screening programme for diabetic retinopathy involves several challenges, often leading to postponements and setbacks at high human and material costs. Thus, it is of the utmost importance to promote the sharing of experiences, successes and difficulties. However, factors such as the existence of regional programmes, specificities of each country's health systems, organizational and even linguistic barriers, make it difficult to create a solid framework that can be used as a basis for future projects.Methods: Web of Science and PubMed platforms were searched using appropriate key words. The review process resulted in 423 articles adherent to the search criteria, 28 of which were accepted and analysed. Web sites of all Portuguese governmental and non-governmental organizations, with a relevant role on the research topic, were inspected and 75 official documents were retrieved and analysed.Results: Since 2001, five regional screening programmes were gradually implemented under the guidelines of Portuguese General Health Department. However, complete population coverage was still not achieved. Among the main difficulties reported are the complex articulation between different levels of care providers, the low number of orthoptic technician in the national health system, the high burden that images grading and treatment of positive cases represents for hospitals ophthalmology services, and low adherence rates. Yet, the comparison between strategies adopted in the different regions allowed the identification of potential solutions: hire orthoptic technician for primary health care units, eliminating the dependence of hospital professionals; use artificial intelligence algorithms for automatic retinographies grading, avoiding ophthalmologists overload; adoption of proximity strategies, as the use of portable retinographers, to promote adherence to screening.Conclusion: Access to diabetic retinopathy screening remains remarkably variable in Portugal and needs urgent attention. However, several characteristics of effective screening programmes were found in Portuguese screening programmes, what seems to point toward promising outcomes, especially if each other highlights are considered. The findings of this research could be very useful for the other countries with similar socio-political characteristics.Registration: PROSPERO registration ID CRD42020200115


2019 ◽  
Vol 2 ◽  
pp. 17 ◽  
Author(s):  
Marsha Tracey ◽  
Emmy Racine ◽  
Fiona Riordan ◽  
Sheena M. McHugh ◽  
Patricia M. Kearney

Background: Diabetic retinopathy (DR) affects 8.2% of the Irish population with type 2 diabetes over 50 years and is one of the leading causes of blindness among working-age adults. Regular diabetic retinopathy screening (DRS) can reduce the risk of sight loss. In 2013, the new national screening programme (RetinaScreen) was introduced in Ireland. Maximising DRS uptake (consent to participate in the programme and attendance once invited) is a priority, therefore it is important to identify characteristics which determine DRS uptake among those with diabetes in Ireland. We report uptake in an Irish primary care population during the initial phase of implementation of RetinaScreen and investigate factors which predict consenting to participate in the programme. Methods:  In two primary care practices, data were extracted from records of people with diabetes (type 1 and type 2) aged ≥18 years who were eligible to participate in RetinaScreen between November 2013 and August 2015. Records were checked for a RetinaScreen letter. RetinaScreen were contacted to establish the status of those without a letter on file. Multivariable Poisson regression was used to examine associations between socio-demographic variables and consenting. Adjusted incident rate ratios (IRR) with 95% CI were generated as a measure of association. Results: Of 722 people with diabetes, one fifth (n=141) were not registered with RetinaScreen. Of 582 who were registered, 63% (n=365) had participated in screening. Most people who consented subsequently attended (n=365/382, 96%). People who had attended another retinopathy screening service were less likely to consent (IRR 0.65 [95%CI 0.5-0.8]; p<0.001). Other predictors were not significantly associated with consent. Conclusions: Over one third of people eligible to participate in RetinaScreen had not consented. Research is needed to understand barriers and enablers of DRS uptake in the Irish context. Implementing strategies to improve DRS uptake (consent and attendance) should be a priority.


2019 ◽  
Vol 2 ◽  
pp. 17 ◽  
Author(s):  
Marsha Tracey ◽  
Emmy Racine ◽  
Fiona Riordan ◽  
Sheena M. McHugh ◽  
Patricia M. Kearney

Background: Diabetic retinopathy (DR) is estimated to affect 25–26% of the Irish population with diabetes and is one of the leading causes of blindness among working-age adults. Regular diabetic retinopathy screening (DRS) can reduce the risk of sight loss. In 2013, the new national screening programme (RetinaScreen) was introduced in Ireland. Maximising DRS uptake (consent to participate in the programme and attendance once invited) is a priority, therefore it is important to identify characteristics which determine DRS uptake among those with diabetes in Ireland. We report uptake in an Irish primary care population during the initial phase of implementation of RetinaScreen and investigate factors which predict consenting to participate in the programme. Methods: In two primary care practices, data were extracted from records of people with diabetes (type 1 and type 2) aged ≥18 years who were eligible to participate in RetinaScreen between November 2013 and August 2015. Records were checked for a RetinaScreen letter. RetinaScreen were contacted to establish the status of those without a letter on file. Multivariable Poisson regression was used to examine associations between socio-demographic variables and consenting. Adjusted incident rate ratios (IRR) with 95% CI were generated as a measure of association. Results: Of 722 people with diabetes, one fifth (n=141) were not registered with RetinaScreen. Of 582 who were registered, 63% (n=365) had participated in screening. Most people who consented subsequently attended (n=365/382, 96%). People who had attended another retinopathy screening service were less likely to consent (IRR 0.65 [95%CI 0.5-0.8]; p<0.001). Other predictors were not significantly associated with consent. Conclusions: Over one third of eligible participants in RetinaScreen had not consented. Research is needed to understand barriers and enablers of DRS uptake in the Irish context. Implementing strategies to improve DRS uptake, barriers to consent in particular, should be a priority.


Sign in / Sign up

Export Citation Format

Share Document