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15-05-2012 | Diabetes | Article

2-year diabetic retinopathy screening interval effective


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MedWire News: Screening patients with Type 2 diabetes every 2 years for retinopathy rather than annually is an effective strategy that could be implemented in the UK, say researchers.

Furthermore, such a policy could reduce the cost of screening by about 25%, thereby mitigating the elevated demand on screening services arising from increased diabetes prevalence, they say.

The UK's National Institute for Health and Clinical Excellence (NICE) guidelines currently recommend that people with diabetes are screened for retinopathy annually. However, "the development of retinopathy may take decades and the annual screening of all diabetes patients may therefore incur considerable health costs and patient inconvenience that, in some cases, is unjustified," remark Daniel Chalk (University of Exeter, Devon, UK) and colleagues.

The team therefore assessed the potential impact of implementing a 2-year retinopathy screening interval in 20,000 Type 2 diabetes patients without retinopathy. "These patients represent about 40% of the Type 1 and Type 2 diabetes population screened by Royal Devon and Exeter, and reductions in the frequency with which they are screened could therefore lead to large potential cost and resource savings," writes the team in Diabetes Care.

The team constructed a new model that stimulates the progression of diabetic retinopathy and patient screening, and allows alterations of parameters that generate predictions based on the impact of certain changes. Data obtained from the Royal Devon and Exeter National Health Service Foundation Trust were used to populate the model and generate comparative 15-year forecasts to assess the differences between the annual and 2-year screening policies.

Chalk and colleagues report that implementing a 2-year screening interval for people with Type 2 diabetes patients without evidence of diabetic retinopathy did not increase their risk for vision loss.

The proportion of patients predicted by the stimulation model to lose their vision within 15 years was 1.9% with both the current screening policy and the proposed one, they say.

Furthermore, over 15 years, the 2-year policy is expected to incur £ 1,360,516 (US$ 2,187,290, € 1,699,600) in costs compared with £1,834,060 (US$ 2,948,600, €2,291,170) incurred with the 1-year policy, representing a significant 25.8% reduction in screening costs if the proposed policy is introduced.

Finally, the 2-year policy would also reduce screening appointments by a significant 737 appointments per year, say Chalk and team.

"The findings support those of other studies," say the researchers who recommend that a review of the current NICE guidelines for diabetic retinopathy screening is implemented in the UK.

MedWire ( is an independent clinical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2012

By Sally Robertson

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