An Optical Practice Based Diabetic Eye Screening Programme

1995 ◽  
Vol 12 (6) ◽  
pp. 531-536 ◽  
Author(s):  
W. Gatling ◽  
A.J. Howie ◽  
R.D. Hill
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 ◽  
Vol 58 (4) ◽  
pp. 521-530
Author(s):  
Peter. H. Scanlon

AbstractThe aim of the English NHS Diabetic Eye Screening Programme (DESP) is to reduce the risk of sight loss amongst people with diabetes by the prompt identification and effective treatment if necessary of sight-threatening diabetic retinopathy, at the appropriate stage during the disease process, with a long-term aim of preventing blindness in people with diabetes.For the year 2009–2010, diabetic retinopathy (DR) was no longer the leading cause of blindness in the working age group. There have been further reductions in DR certifications for WHO severe vision impairment and blindness from 1,334 (5.5% of all certifications) in 2009/2010 to 840 (3.5% of all certifications) in 2018/2019. NHS DESP is a major contributor to this further reduction, but one must also take into account improvements in glycaemic and blood pressure control, timely laser treatment and vitrectomy surgery, improved monitoring techniques for glycaemic control, and vascular endothelial growth factor inhibitor injections for control of diabetic macular oedema. The latter have had a particular impact since first introduced in the UK in 2013.Current plans for NHS DESP include extension of screening intervals in low-risk groups and the introduction of optical coherence tomography as a second line of screening for those with screen positive maculopathy with two dimensional markers. Future challenges include the introduction of automated analysis for grading and new camera technologies.


2021 ◽  
Vol 9 (2) ◽  
pp. e002436
Author(s):  
Louise Prothero ◽  
Fabianna Lorencatto ◽  
Martin Cartwright ◽  
Jennifer M Burr ◽  
Philip Gardner ◽  
...  

IntroductionDiabetic retinopathy screening (DRS) attendance in young adults is consistently below recommended levels. The aim of this study was to conduct a survey of screening providers in the UK Diabetic Eye Screening Programme (DESP) to identify perceived barriers and enablers to DRS attendance in young adults and elicit views on the effectiveness of strategies to improve screening uptake in this population.Research design and methodsMembers of the British Association of Retinal Screening (n=580) were invited to complete an anonymous online survey in July 2020 assessing agreement with 37 belief statements, informed by the Theoretical Domains Framework (TDF) of behavior change, describing potential barrier/enablers to delivering DRS for young adults and further survey items exploring effectiveness of strategies to improve uptake of DRS.ResultsIn total, 140 (24%) responses were received mostly from screener/graders (67.1%). There was a high level of agreement that the DESP had a role in improving attendance in young adults (96.4%) and that more could be done to improve attendance (90.0%). The most commonly reported barriers related to TDF domains Social influences and Environmental context and resources including lack of integration of DRS with other processes of diabetes care, which limited the ability to discuss diabetes self-management. Other barriers included access to screening services and difficulties with scheduling appointments. Less than half (46.4%) of respondents reported having a dedicated strategy to improve screening uptake in young adults. Strategies perceived to be effective included: screening within the community; prompts/reminders and integrating eye screening with other diabetes services.ConclusionsScreening providers were concerned about screening uptake in young adults, although many programs lacked a dedicated strategy to improve attendance. Problems associated with a lack of integration between DRS with other diabetes care processes were identified as a major barrier to providing holistic care to young adults and supporting diabetes self-management.


2020 ◽  
pp. bjophthalmol-2019-315394
Author(s):  
Abraham Olvera-Barrios ◽  
Tjebo FC Heeren ◽  
Konstantinos Balaskas ◽  
Ryan Chambers ◽  
Louis Bolter ◽  
...  

BackgroundPhotographic diabetic retinopathy screening requires labour-intensive grading of retinal images by humans. Automated retinal image analysis software (ARIAS) could provide an alternative to human grading. We compare the performance of an ARIAS using true-colour, wide-field confocal scanning images and standard fundus images in the English National Diabetic Eye Screening Programme (NDESP) against human grading.MethodsCross-sectional study with consecutive recruitment of patients attending annual diabetic eye screening. Imaging with mydriasis was performed (two-field protocol) with the EIDON platform (CenterVue, Padua, Italy) and standard NDESP cameras. Human grading was carried out according to NDESP protocol. Images were processed by EyeArt V.2.1.0 (Eyenuk Inc, Woodland Hills, California). The reference standard for analysis was the human grade of standard NDESP images.ResultsWe included 1257 patients. Sensitivity estimates for retinopathy grades were: EIDON images; 92.27% (95% CI: 88.43% to 94.69%) for any retinopathy, 99% (95% CI: 95.35% to 100%) for vision-threatening retinopathy and 100% (95% CI: 61% to 100%) for proliferative retinopathy. For NDESP images: 92.26% (95% CI: 88.37% to 94.69%) for any retinopathy, 100% (95% CI: 99.53% to 100%) for vision-threatening retinopathy and 100% (95% CI: 61% to 100%) for proliferative retinopathy. One case of vision-threatening retinopathy (R1M1) was missed by the EyeArt when analysing the EIDON images, but identified by the human graders. The EyeArt identified all cases of vision-threatening retinopathy in the standard images.ConclusionEyeArt identified diabetic retinopathy in EIDON images with similar sensitivity to standard images in a large-scale screening programme, exceeding the sensitivity threshold recommended for a screening test. Further work to optimise the identification of ‘no retinopathy’ and to understand the differential lesion detection in the two imaging systems would enhance the use of these two innovative technologies in a diabetic retinopathy screening setting.


2021 ◽  
Vol 1 (3) ◽  
pp. 154-162
Author(s):  
Laura N. Cushley ◽  
Katie Curran ◽  
Nicola B. Quinn ◽  
Aaron Bell ◽  
Alyson Muldrew ◽  
...  

The study aim is to investigate characteristics, barriers and enablers for attendance at the Diabetic Eye Screening Programme Northern Ireland (DESPNI) among people with diabetes aged 12–26 years. A mixed-methods approach with retrospective analysis and prospective, questionnaire-based data collection was completed. Data were analysed using ordinal logistic regression. A questionnaire collected information on barriers and enablers to attending DESPNI. Age, diabetes duration, attendance at diabetes clinic and lower HbA1c values were significantly associated with better attendance. Those aged 12–15 were more likely to attend screening than 16–26 years, odds ratio (OR) 4.01. Subjects diagnosed less than 5 years were more likely to attend than those with longer diabetes duration (OR = 2.52, p =< 0.001). Subjects who attended diabetes clinics were more likely to attend screening (OR = 1.89, p =< 0.001) and have a lower HbA1c (OR = 1.46, p =< 0.001). Questionnaires revealed major barriers to attendance which included inconvenient appointment times, lack of access and poor communication. While many subjects were aware of the impact of diabetes on the eye, many had little understanding of screening. This study provides pivotal information on potential barriers and enablers for young people attending eye screening. We suggest modest changes such as convenient appointment times, clearer communication and one-stop clinics could improve attendance.


2016 ◽  
Vol 33 (12) ◽  
pp. 1612-1614 ◽  
Author(s):  
C. J. Sampson ◽  
M. James ◽  
D. M. Broadbent ◽  
S. P. Harding

Author(s):  
Karen Whitehouse

In all national screening programmes, staff training to confirm competency and accreditation to practice in their profession is required for patient safety. This chapter sets out an example of how the UK diabetic eye programme has evolved in this respect. The current National Vocational Qualifications (NVQ) level 3: Health screener: diabetic eye screening for personnel undertaking screening and grading, will be explained. In some programmes, slit lamp examination is now provided by graders, as well as ophthalmologists and optometrists. The current requirement is detailed. In addition, all grading staff should also participate in test and training of retinal image sets in order to confirm accuracy of grading. At least 10 test sets should be undertaken per annum.


Author(s):  
David K. Roy ◽  
Prashant Amrelia

Early eye screening detection and treatment is fundamental in managing significant complications of chronic disease, both for improving diabetic retinopathy (DR) clinical outcomes and improving the economic burdens. Early detection and subsequent treatment can substantially reduce the risk of blindness from DR. This chapter will review the screening episode, measuring visual acuity, drop instillation, contraindications, and correct camera operation. It will review problems associated with incorrect camera operation and the NHS Diabetic Eye Screening Programme (NHSDESP) standards of acceptable image quality. This will guide the screener in obtaining clear, well-centred, gradable digital images of the retina in diabetic patients with vision better than no perception of light in both eyes, as well as providing a greater understanding of issues associated with screening.


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