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- Title
Screening intervals for diabetic retinopathy and incidence of visual loss: a systematic review.
- Authors
Echouffo–Tcheugui, J. B.; Ali, M. K.; Roglic, G.; Hayward, R. A.; Narayan, K. M.
- Abstract
Screening for diabetic retinopathy can help to prevent this complication, but evidence regarding frequency of screening is uncertain. This paper systematically reviews the published literature on the relationship between screening intervals for diabetic retinopathy and the incidence of visual loss. The PubMed and EMBASE databases were searched until December 2012. Twenty five studies fulfilled the inclusion criteria, as these assessed the incidence/prevalence of sight-threatening diabetic retinopathy in relation to screening frequency. The included studies comprised 15 evaluations of real-world screening programmes, three studies modelling the natural history of diabetic retinopathy and seven cost-effectiveness studies. In evaluations of diabetic retinopathy screening programmes, the appropriate screening interval ranged from one to four years, in people with no retinopathy at baseline. Despite study heterogeneity, the overall tendency observed in these programmes was that 2-year screening intervals among people with no diabetic retinopathy at diagnosis were not associated with high incidence of sight-threatening diabetic retinopathy. The modelling studies (non-economic and economic) assessed a range of screening intervals (1-5 years). The aggregated evidence from both the natural history and cost-effectiveness models favors a screening interval >1 year, but ≤2 years. Such an interval would be appropriate, safe and cost-effective for people with no diabetic retinopathy at diagnosis, while screening intervals ≤1 year would be preferable for people with pre-existing diabetic retinopathy. A 2-year screening interval for people with no sight threatening diabetic retinopathy at diagnosis may be safely adopted. For patients with pre-existing diabetic retinopathy, a shorter interval ≤1 year is warranted.
- Subjects
VISION testing; BLOOD pressure measurement; DATABASES; DIABETES; DIABETIC retinopathy; PEOPLE with diabetes; ECONOMICS; MEDICAL information storage &; retrieval systems; EVALUATION of medical care; MEDICAL care costs; MEDICAL screening; MEDLINE; META-analysis; METABOLIC regulation; ONLINE information services; WORLD Health Organization; DISEASE complications; DIAGNOSIS
- Publication
Diabetic Medicine, 2013, Vol 30, Issue 11, p1272
- ISSN
0742-3071
- Publication type
Article
- DOI
10.1111/dme.12274