Fundamental principles of an effective diabetic retinopathy screening program

Abstract

Background Diabetic retinopathy (DR) is the leading cause of blindness among working-age adults worldwide. Early detection and treatment are necessary to forestall vision loss from DR. Methods A working group of ophthalmic and diabetes experts was established to develop a consensus on the key principles of an effective DR screening program. Recommendations are based on analysis of a structured literature review. Results The recommendations for implementing an effective DR screening program are: (1) Examination methods must be suitable for the screening region, and DR classification/grading systems must be systematic and uniformly applied. Twofield retinal imaging is sufficient for DR screening and is preferable to seven-field imaging, and referable DR should be well defined and reliably identifiable by qualified screening staff; (2) in many countries/regions, screening can and should take place outside the ophthalmology clinic; (3) screening staff should be accredited and show evidence of ongoing training; (4) screening programs should adhere to relevant national quality assurance standards; (5) studies that use uniform definitions of risk to determine optimum risk-based screening intervals are required; (6) technology infrastructure should be in place to ensure that high-quality images can be stored securely to protect patient information; (7) although screening for diabetic macular edema (DME) in conjunction with DR evaluations may have merit, there is currently insufficient evidence to support implementation of programs solely for DME screening. Conclusion Use of these recommendations may yield more effective DR screening programs that reduce the risk of vision loss worldwide.

Support vector machine and deep-learning object detection for localisation of hard exudates

“…Determining the position of hard exudates can be a part of the diabetic macular oedema prediction algorithm. However, screening for diabetic macular oedema alone is currently not advised 33 . The essential parts of diabetic macular oedema examination and follow-up are fluoroangiography and ocular computer tomography examinations 34 .…”

Low serum levels of bone turnover markers are associated with the presence and severity of diabetic retinopathy in patients with type 2 diabetes mellitus

“…The fundus photography was conducted by a trained specialist using a nonmydriatic fundus camera (TRC‐NW400, Topcon, Tokyo, Japan). For each eye, two images were obtained at 45° centered on the macula and optic papilla, which are suggested to be sufficient and superior to seven‐field imaging for effective DR screening, established by ophthalmic and diabetes experts 38 . The diagnosis and grading of DR were carried out by two trained specialists following the criteria of the Early Treatment of Diabetic Retinopathy Study 39 modified according to the clinical practice.…”

Searching for the Antioxidant, Anti-Inflammatory, and Neuroprotective Potential of Natural Food and Nutritional Supplements for Ocular Health in the Mediterranean Population

“…Inflammation/immune response and neurodegeneration processes are common pathogenic mechanisms associated with the most prevalent ocular diseases [1][2][3][4][5][6] The cellular and molecular mechanisms underlying these shifts display interesting similarities.…”

“…It has been recently reported that most challenging ocular disorders are uncorrected/under-corrected refractive errors, ocular surface dysfunction (OSD)/dry eye disease (DED), cataracts, glaucoma, diabetic retinopathy (DR) and age-related macular degeneration (AMD). In fact, severe visual impairment and blindness due to cataract or refractive error constitutes half of all global cases, being glaucoma the most common cause of irreversible blindness [1-3], with DR as the first cause of visual disability in working-age adults [1][2][3][4] and the AMD constituting the first cause of blindness in the elderly [1][2][3][4][5]. Overall, the above disorders seriously impair the quality of life related to vision.…”