Clinical Guidelines for Diabetic Retinopathy: A Summary
Clinical Guidelines for Diabetic Retinopathy: A Summary
NICE has recommended that all adult diabetic patients should have their eyes screened at the time of diagnosis and at least annually thereafter (Level A). Digital photography-based screening is established in the four nations of UK, with some variation in details on grading. It is aimed to improve identification of cases with sight threating retinopathy. Monitoring of screening programme performance against a set of quality assurance standards is the key to successful national screening programmes in all four nations (Level A). Children and adolescents with type I DM should undergo dilated fundus photography annually from age of 12, whereas those with type II DM should undergo dilated fundus photography annually from diagnosis (Level B). People with learning disability should not be excluded from the screening programme.
An ophthalmologist with expertise in DR should provide clinical leadership for the community-based screening programme and a medical retina expert should provide clinical leadership at the hospital eye service for clinical care provided in hospital (Level A). From public health point of view, DR-related visual loss accounted for 17.5% disability in working age population compared with 0.5% from AMD. Ophthalmologists can assist reducing this burden by developing strong links with local primary care and diabetology services to ensure that patients have effective integrated care plans. To address health inequalities, ophthalmologists can assist further public health research such as impact of socio-economic status on DR and what steps can be taken to reduce inequalities in access and outcome (Level B).
Screening for DR
NICE has recommended that all adult diabetic patients should have their eyes screened at the time of diagnosis and at least annually thereafter (Level A). Digital photography-based screening is established in the four nations of UK, with some variation in details on grading. It is aimed to improve identification of cases with sight threating retinopathy. Monitoring of screening programme performance against a set of quality assurance standards is the key to successful national screening programmes in all four nations (Level A). Children and adolescents with type I DM should undergo dilated fundus photography annually from age of 12, whereas those with type II DM should undergo dilated fundus photography annually from diagnosis (Level B). People with learning disability should not be excluded from the screening programme.
An ophthalmologist with expertise in DR should provide clinical leadership for the community-based screening programme and a medical retina expert should provide clinical leadership at the hospital eye service for clinical care provided in hospital (Level A). From public health point of view, DR-related visual loss accounted for 17.5% disability in working age population compared with 0.5% from AMD. Ophthalmologists can assist reducing this burden by developing strong links with local primary care and diabetology services to ensure that patients have effective integrated care plans. To address health inequalities, ophthalmologists can assist further public health research such as impact of socio-economic status on DR and what steps can be taken to reduce inequalities in access and outcome (Level B).
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