Abstract
Purpose :
To analyse the registration, invitation, consent to programme and successful final outcome of diabetic retinopathy screening offered to all diabetic patients on a national basis.
Methods :
We developed a national regsiter from existing drug payment scheme details, existing hospital registries and General Practitioners. A register of 154,961 patients was created. All patients (100%) were invited for screening split over 2013 and 2014 for the first cycle. This is a digital photographic, annualized call / recall process adhering to a Quality Standard. Patients attend one of our 120 screening centres. The retinopathy and maculopathy (R and M) grading system was employed. There is a single electronic patient management system in place (Optomize) to cover screening and treatment arms of the programme. Screening results were analysed and are reported here.
Results :
The total number of patients consenting to screening was 77,024 (49.71%). By the end of 2014 56,841 patients had screening and grading complete.
No retinopathy was detected in 35,769 (62.93%) Background (R1) retinopathy was detected in 13,100 (23.05%) Pre-proliferative (R2) retinopathy was detected in 1138 (2.00%). Proliferative retinopathy (R3) was detected in 1558 (2.67%). Referrable maculopathy (M1) was detected in 4618 (8.12%). Those patients with referrable retinopathy or referrable non-diabetic eye disease were referred to one of 7 treatment centres 7,972 (14.02%). Of these referrals 6454 (11.35%) were routine and 1518 (2.67%) urgent. There were 696 (1.22%) ungradeable images.
Conclusions :
This is the first national record of the extent of diabetic retinal disease in the Irish population. It highlights the prevalence of diabetic retinopathy in Ireland and the number of previously undetected patients with retinopathy. The consent to uptake and final screen/grade needs to be improved but the trends are encouraging. It will provide a valuable benchmark to plan and optomize managment and therapy. As data from treatment centres is crystallized we can report on activity and clinical outcomes. Full visibility on the scale of the Irish Diabetic Retinopathy cohort (following screening and treatment) will be availble after the third cycle.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.