Predicted impact of extending the screening interval for diabetic retinopathy: the Scottish Diabetic Retinopathy Screening programme

H C Looker; S O Nyangoma; D T Cromie; J A Olson; G P Leese; S Philip; M W Black; J Doig; N Lee; A Briggs; E J Hothersall; A D Morris; R S Lindsay; J A McKnight; D W M Pearson; N A Sattar; S H Wild; P McKeigue; H M Colhoun; Scottish Diabetes Research Network (SDRN) Epidemiology group; Scottish Diabetic Retinopathy Collaborative

doi:10.1007/s00125-013-2928-7

Predicted impact of extending the screening interval for diabetic retinopathy: the Scottish Diabetic Retinopathy Screening programme

H C Looker, S O Nyangoma, D T Cromie, J A Olson, G P Leese, S Philip, M W Black, J Doig, N Lee, A Briggs, E J Hothersall, A D Morris, R S Lindsay, J A McKnight, D W M Pearson, N A Sattar, S H Wild, P McKeigue, H M Colhoun, Scottish Diabetes Research Network (SDRN) Epidemiology groupScottish Diabetic Retinopathy Collaborative

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Abstract

Aims/hypothesis
The aim of our study was to identify subgroups of patients attending the Scottish Diabetic Retinopathy Screening (DRS) programme who might safely move from annual to two yearly retinopathy screening.
Methods
This was a retrospective cohort study of screening data from the DRS programme collected between 2005 and 2011 for people aged ≥12 years with type 1 or type 2 diabetes in Scotland. We used hidden Markov models to calculate the probabilities of transitions to referable diabetic retinopathy (referable background or proliferative retinopathy) or referable maculopathy.
Results
The study included 155,114 individuals with no referable diabetic retinopathy or maculopathy at their first DRS examination and with one or more further DRS examinations. There were 11,275 incident cases of referable diabetic eye disease (9,204 referable maculopathy, 2,071 referable background or proliferative retinopathy). The observed transitions to referable background or proliferative retinopathy were lower for people with no visible retinopathy vs mild background retinopathy at their prior examination (respectively, 1.2% vs 8.1% for type 1 diabetes and 0.6% vs 5.1% for type 2 diabetes). The lowest probability for transitioning to referable background or proliferative retinopathy was among people with two consecutive screens showing no visible retinopathy, where the probability was <0.3% for type 1 and <0.2% for type 2 diabetes at 2 years.
Conclusions/interpretation
Transition rates to referable diabetic eye disease were lowest among people with type 2 diabetes and two consecutive screens showing no visible retinopathy. If such people had been offered two yearly screening the DRS service would have needed to screen 40% fewer people in 2009.

Original language	English
Pages (from-to)	1716-1725
Number of pages	10
Journal	Diabetologia
Volume	56
Issue number	8
Early online date	21 May 2013
DOIs	https://doi.org/10.1007/s00125-013-2928-7
Publication status	Published - Aug 2013

Keywords

diabetes
diabetic retinopathy
maculopathy
retinal screening
screening intervals

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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Predicted impact
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Cite this

Looker, H. C., Nyangoma, S. O., Cromie, D. T., Olson, J. A., Leese, G. P., Philip, S., Black, M. W., Doig, J., Lee, N., Briggs, A., Hothersall, E. J., Morris, A. D., Lindsay, R. S., McKnight, J. A., Pearson, D. W. M., Sattar, N. A., Wild, S. H., McKeigue, P., Colhoun, H. M., ... Scottish Diabetic Retinopathy Collaborative (2013). Predicted impact of extending the screening interval for diabetic retinopathy: the Scottish Diabetic Retinopathy Screening programme. Diabetologia, 56(8), 1716-1725. https://doi.org/10.1007/s00125-013-2928-7

Looker, HC, Nyangoma, SO, Cromie, DT, Olson, JA, Leese, GP, Philip, S, Black, MW, Doig, J, Lee, N, Briggs, A, Hothersall, EJ, Morris, AD, Lindsay, RS, McKnight, JA, Pearson, DWM, Sattar, NA, Wild, SH, McKeigue, P, Colhoun, HM, Scottish Diabetes Research Network (SDRN) Epidemiology group & Scottish Diabetic Retinopathy Collaborative 2013, 'Predicted impact of extending the screening interval for diabetic retinopathy: the Scottish Diabetic Retinopathy Screening programme', Diabetologia, vol. 56, no. 8, pp. 1716-1725. https://doi.org/10.1007/s00125-013-2928-7

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title = "Predicted impact of extending the screening interval for diabetic retinopathy: the Scottish Diabetic Retinopathy Screening programme",

abstract = "Aims/hypothesisThe aim of our study was to identify subgroups of patients attending the Scottish Diabetic Retinopathy Screening (DRS) programme who might safely move from annual to two yearly retinopathy screening.MethodsThis was a retrospective cohort study of screening data from the DRS programme collected between 2005 and 2011 for people aged ≥12 years with type 1 or type 2 diabetes in Scotland. We used hidden Markov models to calculate the probabilities of transitions to referable diabetic retinopathy (referable background or proliferative retinopathy) or referable maculopathy.ResultsThe study included 155,114 individuals with no referable diabetic retinopathy or maculopathy at their first DRS examination and with one or more further DRS examinations. There were 11,275 incident cases of referable diabetic eye disease (9,204 referable maculopathy, 2,071 referable background or proliferative retinopathy). The observed transitions to referable background or proliferative retinopathy were lower for people with no visible retinopathy vs mild background retinopathy at their prior examination (respectively, 1.2% vs 8.1% for type 1 diabetes and 0.6% vs 5.1% for type 2 diabetes). The lowest probability for transitioning to referable background or proliferative retinopathy was among people with two consecutive screens showing no visible retinopathy, where the probability was <0.3% for type 1 and <0.2% for type 2 diabetes at 2 years.Conclusions/interpretationTransition rates to referable diabetic eye disease were lowest among people with type 2 diabetes and two consecutive screens showing no visible retinopathy. If such people had been offered two yearly screening the DRS service would have needed to screen 40% fewer people in 2009.",

keywords = "diabetes, diabetic retinopathy, maculopathy, retinal screening, screening intervals",

author = "Looker, {H C} and Nyangoma, {S O} and Cromie, {D T} and Olson, {J A} and Leese, {G P} and S Philip and Black, {M W} and J Doig and N Lee and A Briggs and Hothersall, {E J} and Morris, {A D} and Lindsay, {R S} and McKnight, {J A} and Pearson, {D W M} and Sattar, {N A} and Wild, {S H} and P McKeigue and Colhoun, {H M} and {Scottish Diabetes Research Network (SDRN) Epidemiology group} and {Scottish Diabetic Retinopathy Collaborative}",

year = "2013",

month = aug,

doi = "10.1007/s00125-013-2928-7",

language = "English",

volume = "56",

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journal = "Diabetologia",

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T1 - Predicted impact of extending the screening interval for diabetic retinopathy

T2 - the Scottish Diabetic Retinopathy Screening programme

AU - Looker, H C

AU - Nyangoma, S O

AU - Cromie, D T

AU - Olson, J A

AU - Leese, G P

AU - Philip, S

AU - Black, M W

AU - Doig, J

AU - Lee, N

AU - Briggs, A

AU - Hothersall, E J

AU - Morris, A D

AU - Lindsay, R S

AU - McKnight, J A

AU - Pearson, D W M

AU - Sattar, N A

AU - Wild, S H

AU - McKeigue, P

AU - Colhoun, H M

AU - Scottish Diabetes Research Network (SDRN) Epidemiology group

AU - Scottish Diabetic Retinopathy Collaborative

PY - 2013/8

Y1 - 2013/8

N2 - Aims/hypothesisThe aim of our study was to identify subgroups of patients attending the Scottish Diabetic Retinopathy Screening (DRS) programme who might safely move from annual to two yearly retinopathy screening.MethodsThis was a retrospective cohort study of screening data from the DRS programme collected between 2005 and 2011 for people aged ≥12 years with type 1 or type 2 diabetes in Scotland. We used hidden Markov models to calculate the probabilities of transitions to referable diabetic retinopathy (referable background or proliferative retinopathy) or referable maculopathy.ResultsThe study included 155,114 individuals with no referable diabetic retinopathy or maculopathy at their first DRS examination and with one or more further DRS examinations. There were 11,275 incident cases of referable diabetic eye disease (9,204 referable maculopathy, 2,071 referable background or proliferative retinopathy). The observed transitions to referable background or proliferative retinopathy were lower for people with no visible retinopathy vs mild background retinopathy at their prior examination (respectively, 1.2% vs 8.1% for type 1 diabetes and 0.6% vs 5.1% for type 2 diabetes). The lowest probability for transitioning to referable background or proliferative retinopathy was among people with two consecutive screens showing no visible retinopathy, where the probability was <0.3% for type 1 and <0.2% for type 2 diabetes at 2 years.Conclusions/interpretationTransition rates to referable diabetic eye disease were lowest among people with type 2 diabetes and two consecutive screens showing no visible retinopathy. If such people had been offered two yearly screening the DRS service would have needed to screen 40% fewer people in 2009.

AB - Aims/hypothesisThe aim of our study was to identify subgroups of patients attending the Scottish Diabetic Retinopathy Screening (DRS) programme who might safely move from annual to two yearly retinopathy screening.MethodsThis was a retrospective cohort study of screening data from the DRS programme collected between 2005 and 2011 for people aged ≥12 years with type 1 or type 2 diabetes in Scotland. We used hidden Markov models to calculate the probabilities of transitions to referable diabetic retinopathy (referable background or proliferative retinopathy) or referable maculopathy.ResultsThe study included 155,114 individuals with no referable diabetic retinopathy or maculopathy at their first DRS examination and with one or more further DRS examinations. There were 11,275 incident cases of referable diabetic eye disease (9,204 referable maculopathy, 2,071 referable background or proliferative retinopathy). The observed transitions to referable background or proliferative retinopathy were lower for people with no visible retinopathy vs mild background retinopathy at their prior examination (respectively, 1.2% vs 8.1% for type 1 diabetes and 0.6% vs 5.1% for type 2 diabetes). The lowest probability for transitioning to referable background or proliferative retinopathy was among people with two consecutive screens showing no visible retinopathy, where the probability was <0.3% for type 1 and <0.2% for type 2 diabetes at 2 years.Conclusions/interpretationTransition rates to referable diabetic eye disease were lowest among people with type 2 diabetes and two consecutive screens showing no visible retinopathy. If such people had been offered two yearly screening the DRS service would have needed to screen 40% fewer people in 2009.

KW - diabetes

KW - diabetic retinopathy

KW - maculopathy

KW - retinal screening

KW - screening intervals

U2 - 10.1007/s00125-013-2928-7

DO - 10.1007/s00125-013-2928-7

M3 - Article

C2 - 23689796

SN - 0012-186X

VL - 56

SP - 1716

EP - 1725

JO - Diabetologia

JF - Diabetologia

IS - 8

ER -

Predicted impact of extending the screening interval for diabetic retinopathy: the Scottish Diabetic Retinopathy Screening programme

Abstract

Keywords

UN SDGs

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