The Integration of Diabetic Eye Screening into Hemodialysis Units in Northern Ireland

Cushley, Laura; Quinn, Nicola; Blows, Peter; McKeever, Edward

doi:10.34067/kid.0001802022

Cited by 4 publications

(3 citation statements)

References 6 publications

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“…Hand held cameras have been successfully used to bring DRS to the patient rather than have the patient attend a clinic. 30 , 35 A hand-held camera would be potentially useful to screen those individuals with mobility challenges when positioning their head on the chinrest of a camera.…”

Section: Discussionmentioning

confidence: 99%

Addressing Technical Failures in a Diabetic Retinopathy Screening Program

Brennan,

Kelly,

McBride

et al. 2024

OPTH

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Purpose Diabetic retinopathy (DR) is a preventable cause of blindness detectable through screening using retinal digital photography. The Irish National Diabetic Retina Screening (DRS) programme, Diabetic RetinaScreen, provides free screening services to patients with diabetes from aged 12 years and older. A technical failure (TF) occurs when digital retinal imaging is ungradable, resulting in delays in the diagnosis and treatment of sight-threatening disease. Despite their impact, the causes of TFs, and indeed the utility of interventions to prevent them, have not been extensively examined. Aim Primary analysis aimed to identify factors associated with TF. Secondary analysis examined a subset of cases, assessing patient data from five time points between 2019 and 2021 to identify photographer/patient factors associated with TF. Methods Patient data from the DRS database for one provider were extracted for analysis between 2018 and 2022. Information on patient demographics, screening results, and other factors previously associated with TF were analyzed. Primary analysis involved using mixed-effects logistic regression models with nested patient-eye random effects. Secondary analysis reviewed a subset of cases in detail, checking for causes of TF. Results The primary analysis included a total of 366,528 appointments from 104,407 patients over 5 years. Most patients had Type 2 diabetes (89.2%), and the overall TF rate was 4.9%. Diabetes type and duration, dilate pupil status, and the presence of lens artefacts on the camera were significantly associated with TF. The Secondary analysis identified the primary cause of TF was found to be optically dense cataracts, accounting for over half of the TFs. Conclusion This study provides insight into the causes of TF within the Irish DRS program, highlighting cataracts as the primary contributing factor. The identification of patient-level factors associated with TF facilitates appropriate interventions that can be put in place to improve patient outcomes and minimize delays in treatment and diagnosis.

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Section: Discussionmentioning

confidence: 99%

Addressing Technical Failures in a Diabetic Retinopathy Screening Program

Brennan,

Kelly,

McBride

et al. 2024

OPTH

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“…The number of people with a diagnosis of any type of diabetes in 2019 (108,000) was obtained from the Diabetic Eye Screening Program's Optomize [sic] system. From internal audits, it is estimated the database is over 99% correct (Cushley et al, 2019).…”

Section: Methodsmentioning

confidence: 99%

Certification of Visual Impairment due to Diabetic Eye Disease in Northern Ireland From 2014 to 2019

Cushley

McCann

Moutray

et al. 2023

Journal of Visual Impairment & Blindness

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Purpose: To determine the number of people being certified as either severely sight impaired or sight impaired due to diabetic eye disease (DED) in Northern Ireland (NI). Methods: Sight impairment data have been collected for the 6-year period of 2014–2019, these data included age, gender, certification status, visual acuity, and type of eye disease. All data were entered into an Excel database and analyzed using Stata to ascertain the number of total certifications and diabetic eye disease certifications per year. Results: The number of total certifications in NI increased year on year as has the number of diabetic eye disease certifications. The number of diabetic eye disease certifications rose from 12.6 per million in 2014 to 17.4 per million in 2019, with a peak of 27 per million in 2018. There were more males than females registered due to diabetic eye disease. Diabetic eye disease's proportional representation of total certifications of visual impairment remained relatively stable during the 6-year period. Conclusions: In the 6-year period, the overall number of certifications has increased from 2014 to 2019, as have the number of certifications due to DED. This may be attributed to the improvement of certification and diabetic eye care pathways. People with diabetes who are certified are more likely to be younger and male. More research with medical data needs to be conducted in the future.

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“…In this issue of Kidney360 , Cushley et al describe adherence to annual DR screening in patients receiving hemodialysis and examine the severity of retinopathy detected via a screening program instituted at hemodialysis clinics in Northern Ireland (14). All patients receiving hemodialysis with comorbid diabetes were invited to participate in the DR screening program, and 132 (89%) of eligible patients enrolled and attended screening.…”

mentioning

confidence: 99%