Evaluation of the initial implementation of a nationwide diabetic retinopathy screening programme in primary care: a multimethod study

Khou, Vincent; Khan, Muhammad Azaan; Jiang, Ivy; Katalinic, Paula; Agar, Ashish; Zangerl, Barbara

doi:10.1136/bmjopen-2020-044805

Cited by 4 publications

(1 citation statement)

References 34 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…[ 7 ] In the absence of systematic DR screening in many countries in Europe, the opportunities to prevent people from developing vision impairment and blindness get missed while systematic programs have yielded success. [ 36 37 ] Systematic tele-screening programs for DR have been shown to be cost-effective in India, Singapore, and in meta-analyses. [ 38 39 40 ] Systematic DR screening program contributed to DR no longer being the leading cause of certifiable blindness among the working-age adults in England and Wales.…”

Section: The Way Forward For Systematic Dr Screening In Public Sector...mentioning

confidence: 99%

Diabetic retinopathy screening in the public sector in India: What is needed?

Gupta

Azad

Vashist³

et al. 2022

Indian Journal of Ophthalmology

View full text Add to dashboard Cite

India has been witnessing an epidemic of diabetes for several years now. A large proportion of patients with undiagnosed and poorly controlled diabetes are at great risk of developing diabetic retinopathy (DR) and irreversible blindness. The goal of DR screening is to identify people with sight-threatening DR early so that prompt treatment can be initiated, and blindness can be prevented. Systematic DR screening is essential to identify disease early, and a national effort for the same is required. We adopt a health system approach to outline the actions that need to take place for effective DR screening in the public sector in India. We discuss the role of national leadership, needs assessment, finalization of DR screening and referral pathway, trainings, strategies to improve the uptake, allocation of roles and responsibilities, public-private partnerships, quality control, and financing.

show abstract

Section: The Way Forward For Systematic Dr Screening In Public Sector...mentioning

confidence: 99%

Diabetic retinopathy screening in the public sector in India: What is needed?

Gupta

Azad

Vashist³

et al. 2022

Indian Journal of Ophthalmology

View full text Add to dashboard Cite

show abstract

Deep learning system to predict the 5-year risk of high myopia using fundus imaging in children

et al. 2023

View full text Add to dashboard Cite

Our study aims to identify children at risk of developing high myopia for timely assessment and intervention, preventing myopia progression and complications in adulthood through the development of a deep learning system (DLS). Using a school-based cohort in Singapore comprising of 998 children (aged 6–12 years old), we train and perform primary validation of the DLS using 7456 baseline fundus images of 1878 eyes; with external validation using an independent test dataset of 821 baseline fundus images of 189 eyes together with clinical data (age, gender, race, parental myopia, and baseline spherical equivalent (SE)). We derive three distinct algorithms – image, clinical and mix (image + clinical) models to predict high myopia development (SE ≤ −6.00 diopter) during teenage years (5 years later, age 11–17). Model performance is evaluated using area under the receiver operating curve (AUC). Our image models (Primary dataset AUC 0.93–0.95; Test dataset 0.91–0.93), clinical models (Primary dataset AUC 0.90–0.97; Test dataset 0.93–0.94) and mixed (image + clinical) models (Primary dataset AUC 0.97; Test dataset 0.97–0.98) achieve clinically acceptable performance. The addition of 1 year SE progression variable has minimal impact on the DLS performance (clinical model AUC 0.98 versus 0.97 in primary dataset, 0.97 versus 0.94 in test dataset; mixed model AUC 0.99 versus 0.97 in primary dataset, 0.95 versus 0.98 in test dataset). Thus, our DLS allows prediction of the development of high myopia by teenage years amongst school-going children. This has potential utility as a clinical-decision support tool to identify “at-risk” children for early intervention.

show abstract