Screening für diabetische Retinopathie bei Typ-2-Diabetes: Eine kritische Evaluation der jährlichen Routine

Trends of barriers to eye care among adults with diagnosed diabetes in Germany, 1997–2012

“…In particular, participants with diabetes who had visited a general practitioner or internist during the past year were less likely to report an annual eye care visit. Previous research indicates a lack of attention to screening for diabetic retinopathy among general practitioners [10,19] but the exact reasons for this insufficient utilization of eye care among those with access to general medical services remains to be proven and investigated by future studies. The decrease of yearly contacts to eye-care providers was more pronounced in groups that are more affected by poor glycemic control and diabetes-related complications and comorbidities [44,45].…”

“…However, physicians treating patients with diabetes are often not following guidelines to recommend annual comprehensive eye examination, often do not remind patients with diabetes to seek eye care, and do not refer diabetic patients to a qualified optometrist or ophthalmologist [21,53e55]. While the U.S. and UK are considering to extend the screening interval for those without preexisting diabetic eye disease and mild diabetes beyond the established one year interval [12,14,56,57], guidelines in Germany still recommend yearly examinations for all diabetic patients [10,11]. Screening for diabetic eye disease should focus on subjects with poor diabetic control, co-existing diabetic complications and comorbidities.…”

“…Compliance with consulting eye care specialists among the most vulnerable diabetes populations at recommended intervals might be enhanced by improving access to eye care and implementing and expanding existing educational programs to raise awareness regarding the importance of routine follow-up eye examinations. More research is needed to assess whether improved access and compliance with the recommended follow-up examinations result in improved diabetes outcomes, including reduction in vision loss, in Germany [10,50]. Evidence from the U.S. suggests that regular checkups can reduce low vision and blindness [15].…”

“…Yet, despite the recommendation of regular check-up examination, receipt of the recommended examinations remains quite low [15], especially in European countries [13] e only 30%e53% of those with diabetes have annual eye examinations [16e18]. Research indicates a lack of attention to screening for diabetic retinopathy among general practitioners, diabetes specialists and low compliance with obtaining eye examinations at recommended intervals among patients with diabetes [10,19]. In the U.S., lack of insurance and financial constraints are frequently mentioned reasons for not having an annual eye-care visits by adults with diabetes [19e22].…”

Retinal Capillary Rarefaction in Patients with Type 2 Diabetes Mellitus

“…[42] In future, measurement of retinal capillary rarefaction with SLDF might be included in the yearly assessment. We suggest that the assessment of capillary rarefaction might be superior to retinopathy screening to identify patients at risk of developing end-organ damage at a very early stage.…”