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

doi:10.1136/bjophthalmol-2013-303948

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 language	English
Pages (from-to)	790-795
Number of pages	6
Journal	British Journal of Ophthalmology
Volume	98
Issue number	6
Early online date	5 Mar 2014
DOIs	https://doi.org/10.1136/bjophthalmol-2013-303948
Publication status	Published - Jun 2014

Bibliographical note

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.

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

UN SDGs

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

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10.1136/bjophthalmol-2013-303948

Rates of referable eye disease in the Scottish National Diabetic Retinopathy Screening Programme
This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 3.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See: http://creativecommons.org/licenses/by/3.0/
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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, S., Wild, S. H., Colhoun, H. M., & 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

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

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title = "Rates of referable eye disease in the Scottish National Diabetic Retinopathy Screening Programme",

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.",

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",

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

note = "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.",

year = "2014",

month = jun,

doi = "10.1136/bjophthalmol-2013-303948",

language = "English",

volume = "98",

pages = "790--795",

journal = "British Journal of Ophthalmology",

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T1 - Rates of referable eye disease in the Scottish National 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 - 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.

KW - Adult

KW - Aged

KW - Blindness

KW - Blood Pressure

KW - Databases, Factual

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

U2 - 10.1136/bjophthalmol-2013-303948

DO - 10.1136/bjophthalmol-2013-303948

M3 - Article

C2 - 24599419

SN - 0007-1161

VL - 98

SP - 790

EP - 795

JO - British Journal of Ophthalmology

JF - British Journal of Ophthalmology

IS - 6

ER -

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

Abstract

Bibliographical note

Keywords

UN SDGs

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