Rates of referable eye disease in the Scottish National Diabetic Retinopathy Screening Programme

H C Looker, S O Nyangoma, D T Cromie, J A Olson, G P Leese, M W Black, J Doig, N Lee, R S Lindsay, J A McKnight, A D Morris, D W M Pearson, Sam Philip, S H Wild, H M Colhoun, Scottish Diabetes Research Network (SDRN) Epidemiology group

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Abstract

AIMS: Diabetic retinopathy screening aims to detect people at risk of visual loss due to proliferative diabetic retinopathy, but also refers cases of suspected macular oedema (maculopathy). At the introduction of screening, ophthalmology was concerned that referral rates would be unmanageable. We report yield of referable disease by referral reason for the first 5 years of the programme.

METHODS: We extracted screening results from a nationwide clinical diabetes database to calculate annual referral rates to ophthalmic clinics. We used logistic regression to examine associations between clinical measures and referable disease.

RESULTS: 182 397 people underwent ≥ 1successful retinal screening between 2006 and 2010. The yield of referable eye disease was highest in the first 2 years of screening (7.0% and 6.0%) before stabilising at ∼4.3%. The majority of referrals are due to maculopathy with 73% of referrals in 2010 based on a finding of maculopathy.

CONCLUSIONS: The commonest cause for referral is for suspected macular oedema (maculopathy). Referral rates for retinopathy have stabilised, as predicted, at relatively low rates. However, ophthalmology workload continues to rise as new treatment options (ie, monthly intraocular injections) have unexpectedly increased the impact on ophthalmology. A review of the screening referral path for maculopathy may be timely.

Original languageEnglish
Pages (from-to)790-795
Number of pages6
JournalBritish Journal of Ophthalmology
Volume98
Issue number6
Early online date5 Mar 2014
DOIs
Publication statusPublished - Jun 2014

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Eye Diseases
Diabetic Retinopathy
Referral and Consultation
Ophthalmology
Macular Edema
Intraocular Injections
Workload
Logistic Models
Databases

Keywords

  • Adult
  • Aged
  • Blindness
  • Blood Pressure
  • Databases, Factual
  • Diabetes Mellitus, Type 1
  • Diabetes Mellitus, Type 2
  • Diabetic Retinopathy
  • Female
  • Humans
  • Macular Edema
  • Male
  • Middle Aged
  • National Health Programs
  • Referral and Consultation
  • Registries
  • Risk Factors
  • Scotland

Cite this

Looker, H. C., Nyangoma, S. O., Cromie, D. T., Olson, J. A., Leese, G. P., Black, M. W., ... Scottish Diabetes Research Network (SDRN) Epidemiology group (2014). Rates of referable eye disease in the Scottish National Diabetic Retinopathy Screening Programme. British Journal of Ophthalmology, 98(6), 790-795. https://doi.org/10.1136/bjophthalmol-2013-303948

Rates of referable eye disease in the Scottish National Diabetic Retinopathy Screening Programme. / Looker, H C; Nyangoma, S O; Cromie, D T; Olson, J A; Leese, G P; Black, M W; Doig, J; Lee, N; Lindsay, R S; McKnight, J A; Morris, A D; Pearson, D W M; Philip, Sam; Wild, S H; Colhoun, H M; Scottish Diabetes Research Network (SDRN) Epidemiology group.

In: British Journal of Ophthalmology, Vol. 98, No. 6, 06.2014, p. 790-795.

Research output: Contribution to journalArticle

Looker, HC, Nyangoma, SO, Cromie, DT, Olson, JA, Leese, GP, Black, MW, Doig, J, Lee, N, Lindsay, RS, McKnight, JA, Morris, AD, Pearson, DWM, Philip, S, Wild, SH, Colhoun, HM & Scottish Diabetes Research Network (SDRN) Epidemiology group 2014, 'Rates of referable eye disease in the Scottish National Diabetic Retinopathy Screening Programme', British Journal of Ophthalmology, vol. 98, no. 6, pp. 790-795. https://doi.org/10.1136/bjophthalmol-2013-303948
Looker, H C ; Nyangoma, S O ; Cromie, D T ; Olson, J A ; Leese, G P ; Black, M W ; Doig, J ; Lee, N ; Lindsay, R S ; McKnight, J A ; Morris, A D ; Pearson, D W M ; Philip, Sam ; Wild, S H ; Colhoun, H M ; Scottish Diabetes Research Network (SDRN) Epidemiology group. / Rates of referable eye disease in the Scottish National Diabetic Retinopathy Screening Programme. In: British Journal of Ophthalmology. 2014 ; Vol. 98, No. 6. pp. 790-795.
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abstract = "AIMS: Diabetic retinopathy screening aims to detect people at risk of visual loss due to proliferative diabetic retinopathy, but also refers cases of suspected macular oedema (maculopathy). At the introduction of screening, ophthalmology was concerned that referral rates would be unmanageable. We report yield of referable disease by referral reason for the first 5 years of the programme.METHODS: We extracted screening results from a nationwide clinical diabetes database to calculate annual referral rates to ophthalmic clinics. We used logistic regression to examine associations between clinical measures and referable disease.RESULTS: 182 397 people underwent ≥ 1successful retinal screening between 2006 and 2010. The yield of referable eye disease was highest in the first 2 years of screening (7.0{\%} and 6.0{\%}) before stabilising at ∼4.3{\%}. The majority of referrals are due to maculopathy with 73{\%} of referrals in 2010 based on a finding of maculopathy.CONCLUSIONS: The commonest cause for referral is for suspected macular oedema (maculopathy). Referral rates for retinopathy have stabilised, as predicted, at relatively low rates. However, ophthalmology workload continues to rise as new treatment options (ie, monthly intraocular injections) have unexpectedly increased the impact on ophthalmology. A review of the screening referral path for maculopathy may be timely.",
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AU - Looker, H C

AU - Nyangoma, S O

AU - Cromie, D T

AU - Olson, J A

AU - Leese, G P

AU - Black, M W

AU - Doig, J

AU - Lee, N

AU - Lindsay, R S

AU - McKnight, J A

AU - Morris, A D

AU - Pearson, D W M

AU - Philip, Sam

AU - Wild, S H

AU - Colhoun, H M

AU - Scottish Diabetes Research Network (SDRN) Epidemiology group

N1 - Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

PY - 2014/6

Y1 - 2014/6

N2 - AIMS: Diabetic retinopathy screening aims to detect people at risk of visual loss due to proliferative diabetic retinopathy, but also refers cases of suspected macular oedema (maculopathy). At the introduction of screening, ophthalmology was concerned that referral rates would be unmanageable. We report yield of referable disease by referral reason for the first 5 years of the programme.METHODS: We extracted screening results from a nationwide clinical diabetes database to calculate annual referral rates to ophthalmic clinics. We used logistic regression to examine associations between clinical measures and referable disease.RESULTS: 182 397 people underwent ≥ 1successful retinal screening between 2006 and 2010. The yield of referable eye disease was highest in the first 2 years of screening (7.0% and 6.0%) before stabilising at ∼4.3%. The majority of referrals are due to maculopathy with 73% of referrals in 2010 based on a finding of maculopathy.CONCLUSIONS: The commonest cause for referral is for suspected macular oedema (maculopathy). Referral rates for retinopathy have stabilised, as predicted, at relatively low rates. However, ophthalmology workload continues to rise as new treatment options (ie, monthly intraocular injections) have unexpectedly increased the impact on ophthalmology. A review of the screening referral path for maculopathy may be timely.

AB - AIMS: Diabetic retinopathy screening aims to detect people at risk of visual loss due to proliferative diabetic retinopathy, but also refers cases of suspected macular oedema (maculopathy). At the introduction of screening, ophthalmology was concerned that referral rates would be unmanageable. We report yield of referable disease by referral reason for the first 5 years of the programme.METHODS: We extracted screening results from a nationwide clinical diabetes database to calculate annual referral rates to ophthalmic clinics. We used logistic regression to examine associations between clinical measures and referable disease.RESULTS: 182 397 people underwent ≥ 1successful retinal screening between 2006 and 2010. The yield of referable eye disease was highest in the first 2 years of screening (7.0% and 6.0%) before stabilising at ∼4.3%. The majority of referrals are due to maculopathy with 73% of referrals in 2010 based on a finding of maculopathy.CONCLUSIONS: The commonest cause for referral is for suspected macular oedema (maculopathy). Referral rates for retinopathy have stabilised, as predicted, at relatively low rates. However, ophthalmology workload continues to rise as new treatment options (ie, monthly intraocular injections) have unexpectedly increased the impact on ophthalmology. A review of the screening referral path for maculopathy may be timely.

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KW - Blood Pressure

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KW - Diabetes Mellitus, Type 1

KW - Diabetes Mellitus, Type 2

KW - Diabetic Retinopathy

KW - Female

KW - Humans

KW - Macular Edema

KW - Male

KW - Middle Aged

KW - National Health Programs

KW - Referral and Consultation

KW - Registries

KW - Risk Factors

KW - Scotland

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DO - 10.1136/bjophthalmol-2013-303948

M3 - Article

C2 - 24599419

VL - 98

SP - 790

EP - 795

JO - British Journal of Ophthalmology

JF - British Journal of Ophthalmology

SN - 0007-1161

IS - 6

ER -