Skip to main content
Top
Published in: Current Diabetes Reports 4/2012

01-08-2012 | Microvascular Complications—Retinopathy (JK Sun, Section Editor)

Screening for Diabetic Retinopathy and Diabetic Macular Edema in the United Kingdom

Authors: Tunde Peto, Christine Tadros

Published in: Current Diabetes Reports | Issue 4/2012

Login to get access

Abstract

Despite advances in screening for and treatment of diabetes, diabetic retinopathy and maculopathy are still major causes of visual loss around the world. Systematic screening programs for diabetic eye disease have been developed in many countries. The main aim of these services is to reduce diabetes-related blindness and ease the burden of illness on the patients and their families. In the United Kingdom (UK), the NHS Diabetic Eye Screening Program offers annual digital fundus photography for all patients with diabetes over the age of 12 years regardless of their socio-economic status or ethnicity. In 2010–2011 a nationwide uptake of 79% was achieved. If disease is identified, referral to a specialized eye unit for further assessment and treatment are organized to take place within a pre-specified time frame. Internal and external quality assurance ensures efficacy and safety. This paper aims to summarize the current situation of diabetic retinopathy screening in the UK and outlines the challenges ahead.
Literature
1.
go back to reference Duh E, Chung N, Wong T. Diabetic retinopathy and systemic complications. In: Duh E, editor. Diabetic retinopathy. New Jersey: Humana Press; 2009. p. 465–82. Duh E, Chung N, Wong T. Diabetic retinopathy and systemic complications. In: Duh E, editor. Diabetic retinopathy. New Jersey: Humana Press; 2009. p. 465–82.
4.
go back to reference Early Treatment Diabetic Retinopathy Study Research Group. Fundus photographic risk factors for progression of diabetic retinopathy. ETDRS report number 12. Ophthalmology. 1991;98:823–33. Early Treatment Diabetic Retinopathy Study Research Group. Fundus photographic risk factors for progression of diabetic retinopathy. ETDRS report number 12. Ophthalmology. 1991;98:823–33.
5.
go back to reference Tanner V. Diabetic retinopathy. In: Kanski JJ, editor Clinical ophthalmology—a systematic approach. Philadelphia: Elsevier, 2007; 573. Tanner V. Diabetic retinopathy. In: Kanski JJ, editor Clinical ophthalmology—a systematic approach. Philadelphia: Elsevier, 2007; 573.
6.
go back to reference Wright AD, Dodson PM. Medical management of diabetic retinopathy: fenofibrate and accord eye studies. Eye. 2011;25:843–9.PubMedCrossRef Wright AD, Dodson PM. Medical management of diabetic retinopathy: fenofibrate and accord eye studies. Eye. 2011;25:843–9.PubMedCrossRef
7.
go back to reference United Kingdom Prospective Diabetes Study Group. Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). Lancet. 1998;352:837–85.CrossRef United Kingdom Prospective Diabetes Study Group. Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). Lancet. 1998;352:837–85.CrossRef
8.
go back to reference The effect of intensive diabetes treatment on the progression of diabetic retinopathy in insulin dependent diabetes mellitus. the Diabetes Control and Complication Trial. Arch Ophthalmol 1995;113:36–51 The effect of intensive diabetes treatment on the progression of diabetic retinopathy in insulin dependent diabetes mellitus. the Diabetes Control and Complication Trial. Arch Ophthalmol 1995;113:36–51
9.
go back to reference Massin P, Bandello F, Garweg JG, et al. Safety and efficacy of ranibizumab in diabetic macular oedema (RESOLVE Study): a 12-month, randomized, controlled, double masked multicentre phase II study. Diabetes Care. 2010;33:2399–405.PubMedCrossRef Massin P, Bandello F, Garweg JG, et al. Safety and efficacy of ranibizumab in diabetic macular oedema (RESOLVE Study): a 12-month, randomized, controlled, double masked multicentre phase II study. Diabetes Care. 2010;33:2399–405.PubMedCrossRef
10.
go back to reference Mitchell P, Bandello F, Schmidt-Ehrfurt U, et al. The RESTORE study: ranibizumab monotherapy or combined with laser versus laser monotherapy for diabetic macular oedema. Ophthalmology. 2011;118:615–25.PubMedCrossRef Mitchell P, Bandello F, Schmidt-Ehrfurt U, et al. The RESTORE study: ranibizumab monotherapy or combined with laser versus laser monotherapy for diabetic macular oedema. Ophthalmology. 2011;118:615–25.PubMedCrossRef
11.
go back to reference Diabetic Retinopathy Clinical Research Network. Randomised clinical trial evaluating ranibizumab plus prompt or deferred laser or triamcinolone plus prompt laser for diabetic maculae oedema. Ophthalmology. 2010;117:1064–77.CrossRef Diabetic Retinopathy Clinical Research Network. Randomised clinical trial evaluating ranibizumab plus prompt or deferred laser or triamcinolone plus prompt laser for diabetic maculae oedema. Ophthalmology. 2010;117:1064–77.CrossRef
12.
go back to reference Michaelides M, Kaines A, Hamilton RD, et al. A prospective randomised trial of intravitreal bevacizumab or laser therapy in the management of diabetic macular oedema. (BOLT Study) 12 months data: Report 2. Ophthalmology. 2010;117:1078–86.PubMedCrossRef Michaelides M, Kaines A, Hamilton RD, et al. A prospective randomised trial of intravitreal bevacizumab or laser therapy in the management of diabetic macular oedema. (BOLT Study) 12 months data: Report 2. Ophthalmology. 2010;117:1078–86.PubMedCrossRef
16.
go back to reference Stefansson E, Bek T, Porta M, et al. Screening and prevention of diabetic blindness. Acta Ophthalmol Scand. 2000;78:374–85.PubMedCrossRef Stefansson E, Bek T, Porta M, et al. Screening and prevention of diabetic blindness. Acta Ophthalmol Scand. 2000;78:374–85.PubMedCrossRef
17.
go back to reference Scanlon PH. The English National screening programme for sight-threatening diabetic retinopathy. J Med Screen. 2008;15(1):1–4.PubMedCrossRef Scanlon PH. The English National screening programme for sight-threatening diabetic retinopathy. J Med Screen. 2008;15(1):1–4.PubMedCrossRef
18.
go back to reference Arora S, Kolb S, Goyder E, McKibbin MM. Trends in the incidence of visual impairment resulting from diabetic retinopathy in the Leeds metropolitan area, 2005–2010. Diabet Med. 2012 Feb 22. [Epub ahead of print]. Arora S, Kolb S, Goyder E, McKibbin MM. Trends in the incidence of visual impairment resulting from diabetic retinopathy in the Leeds metropolitan area, 2005–2010. Diabet Med. 2012 Feb 22. [Epub ahead of print].
20.
go back to reference • Klein R, Klein BEK. Are individuals with diabetes seeing better? A long-term epidemiological perspective. Diabetes. 2010;59(8):1853–60. This paper is of importance as it is a good review of major studies that examine the relationship between diabetic retinopathy and systemic risk factors.PubMedCrossRef • Klein R, Klein BEK. Are individuals with diabetes seeing better? A long-term epidemiological perspective. Diabetes. 2010;59(8):1853–60. This paper is of importance as it is a good review of major studies that examine the relationship between diabetic retinopathy and systemic risk factors.PubMedCrossRef
21.
go back to reference Ahola AJ, Saraheimo M, Forsblom C, et al; FinnDiane Study Group. Health-related quality of life in patients with type 1 diabetes—association with diabetic complications (the FinnDiane Study). Nephrol Dial Transplant. 2010;25(6):1903-8. Ahola AJ, Saraheimo M, Forsblom C, et al; FinnDiane Study Group. Health-related quality of life in patients with type 1 diabetes—association with diabetic complications (the FinnDiane Study). Nephrol Dial Transplant. 2010;25(6):1903-8.
22.
go back to reference Davidov E, Breitscheidel L, Clouth J, et al. Diabetic retinopathy and health-related quality of life. Graefes Arch Clin Exp Ophthalmol. 2009;247(2):267–72.PubMedCrossRef Davidov E, Breitscheidel L, Clouth J, et al. Diabetic retinopathy and health-related quality of life. Graefes Arch Clin Exp Ophthalmol. 2009;247(2):267–72.PubMedCrossRef
23.
go back to reference Gabrielian A, Hariprasad SM, Jager RD, et al. The utility of visual function questionnaire in the assessment of the impact of diabetic retinopathy on vision-related quality of life. Eye. 2010;124:29–35.CrossRef Gabrielian A, Hariprasad SM, Jager RD, et al. The utility of visual function questionnaire in the assessment of the impact of diabetic retinopathy on vision-related quality of life. Eye. 2010;124:29–35.CrossRef
24.
go back to reference Hariprasad SM, Mieler WF, Grassi JL, et al. Vision-related quality of life in patients with diabetic macular edema. Br J Ophthalmol. 2008;92(1):89–92.PubMedCrossRef Hariprasad SM, Mieler WF, Grassi JL, et al. Vision-related quality of life in patients with diabetic macular edema. Br J Ophthalmol. 2008;92(1):89–92.PubMedCrossRef
25.
go back to reference Zoega GM, Gunnarsdottir T, Bjornsdottir S, et al. Screening compliance and visual outcome in diabetes. Acta Ophthalmol Scand. 2005;83(6):687–90.PubMedCrossRef Zoega GM, Gunnarsdottir T, Bjornsdottir S, et al. Screening compliance and visual outcome in diabetes. Acta Ophthalmol Scand. 2005;83(6):687–90.PubMedCrossRef
26.
go back to reference Yeo ST, Edwards RT, Fargher EA, et al. Preferences of people with diabetes for diabetic retinopathy screening: a discrete choice experiment. Diabet Med. 2012 March13. [Epub ahead of print]. Yeo ST, Edwards RT, Fargher EA, et al. Preferences of people with diabetes for diabetic retinopathy screening: a discrete choice experiment. Diabet Med. 2012 March13. [Epub ahead of print].
28.
go back to reference Crijns H, Hendrikse F. Continuous computer simulation analysis of the cost-effectiveness of screening and treating diabetic retinopathy. Int J Technol Assess Health Care. 1999;15:0198–206.CrossRef Crijns H, Hendrikse F. Continuous computer simulation analysis of the cost-effectiveness of screening and treating diabetic retinopathy. Int J Technol Assess Health Care. 1999;15:0198–206.CrossRef
29.
go back to reference Polak BC, Crijns H, Casparie AF, Niessen LW. Cost-effectiveness of glycaemic control and ophthalmological care in diabetic retinopathy. Health Policy. 2003;64:89–97.PubMedCrossRef Polak BC, Crijns H, Casparie AF, Niessen LW. Cost-effectiveness of glycaemic control and ophthalmological care in diabetic retinopathy. Health Policy. 2003;64:89–97.PubMedCrossRef
30.
go back to reference James M, Turner DA, Broadbent DM, et al. Cost effectiveness analysis of screening for sight threatening diabetic eye disease. Br Med J. 2000;320:1627–31.CrossRef James M, Turner DA, Broadbent DM, et al. Cost effectiveness analysis of screening for sight threatening diabetic eye disease. Br Med J. 2000;320:1627–31.CrossRef
32.
go back to reference Scott IU, Edwards AR, Aiello LP, et al. A phase II randomized clinical trial of intravitreal bevacizumab for diabetic macular edema. diabetic retinopathy clinical research network. Ophthalmol. 2007;114:1860–7.CrossRef Scott IU, Edwards AR, Aiello LP, et al. A phase II randomized clinical trial of intravitreal bevacizumab for diabetic macular edema. diabetic retinopathy clinical research network. Ophthalmol. 2007;114:1860–7.CrossRef
33.
go back to reference Beck RW, Edwards AR, Aiello LP, et al. Three-year follow-up of a randomized trial comparing focal/grid photocoagulation and intravitreal triamcinolone for diabetic macular edema. Diabetic Retinopathy Clinical Research Network (DRCR.net). Arch Ophthalmol. 2009;127:245–51.PubMedCrossRef Beck RW, Edwards AR, Aiello LP, et al. Three-year follow-up of a randomized trial comparing focal/grid photocoagulation and intravitreal triamcinolone for diabetic macular edema. Diabetic Retinopathy Clinical Research Network (DRCR.net). Arch Ophthalmol. 2009;127:245–51.PubMedCrossRef
34.
go back to reference Aiello LP, Edwards AR, Beck RW, et al. Factors associated with improvement and worsening of visual acuity 2 years after focal/grid photocoagulation for diabetic macular edema. Diabetic retinopathy clinical research network. Ophthalmol. 2010;117:946–53.CrossRef Aiello LP, Edwards AR, Beck RW, et al. Factors associated with improvement and worsening of visual acuity 2 years after focal/grid photocoagulation for diabetic macular edema. Diabetic retinopathy clinical research network. Ophthalmol. 2010;117:946–53.CrossRef
35.
go back to reference Glassman AR, Beck RW, Brownning DJ, et al. Comparison of optical coherence tomography in diabetic macular edema, with and without reading center manual grading from a clinical trials prospective. Diabetic Retinopathy Clinical Research Network Study Group. Invest Ophthalmol Vis Sci. 2009;50:560–6.PubMedCrossRef Glassman AR, Beck RW, Brownning DJ, et al. Comparison of optical coherence tomography in diabetic macular edema, with and without reading center manual grading from a clinical trials prospective. Diabetic Retinopathy Clinical Research Network Study Group. Invest Ophthalmol Vis Sci. 2009;50:560–6.PubMedCrossRef
36.
go back to reference • Mackenzie S, Schmermer C, et al. SDOCT imaging to identify macular pathology in patients diagnosed with diabetic maculopathy by a digital photographic retinal screening programme. PLoS one 2011;6(5);e14811. This abstract combines the assessment of new technology with assessment of a new pathway and is conducted in a clinic setting . • Mackenzie S, Schmermer C, et al. SDOCT imaging to identify macular pathology in patients diagnosed with diabetic maculopathy by a digital photographic retinal screening programme. PLoS one 2011;6(5);e14811. This abstract combines the assessment of new technology with assessment of a new pathway and is conducted in a clinic setting .
37.
go back to reference Virgili G, Menchini F, Dimastogiovanni AF, et al. Optical coherence tomography versus stereoscopic fundus photography or biomicroscopy for diagnosing diabetic macular edema: a systematic review. Invest Ophthalmol Vis Sci. 2007;49:2627–34. Virgili G, Menchini F, Dimastogiovanni AF, et al. Optical coherence tomography versus stereoscopic fundus photography or biomicroscopy for diagnosing diabetic macular edema: a systematic review. Invest Ophthalmol Vis Sci. 2007;49:2627–34.
38.
go back to reference • Noble J, Silva PS, Cavallerano JD, et al. Comparison of nonmydriatic optos® fundus imaging with mydriatic Early Treatment Diabetic Retinopathy Study (ETDRS) 7-Standard field stereo photography and clinical grading. ARVO 20011:Abstract 1283. This abstract shows an excellent example of a well-conducted validation study for new technology. • Noble J, Silva PS, Cavallerano JD, et al. Comparison of nonmydriatic optos® fundus imaging with mydriatic Early Treatment Diabetic Retinopathy Study (ETDRS) 7-Standard field stereo photography and clinical grading. ARVO 20011:Abstract 1283. This abstract shows an excellent example of a well-conducted validation study for new technology.
39.
go back to reference •• Goatman K, Charnley A, Webster L and Nussey S. Assessment of automated disease detection in diabetic retinopathy screening using two-field photography. PLOS one 2011;6(12) This paper opens up a new avenue on automated grading. •• Goatman K, Charnley A, Webster L and Nussey S. Assessment of automated disease detection in diabetic retinopathy screening using two-field photography. PLOS one 2011;6(12) This paper opens up a new avenue on automated grading.
40.
go back to reference Stefansson E, Bek T, Porta M, et al. Screening and prevention of diabetic blindness. Acta Ophth Scand. 2000;78:374–85.CrossRef Stefansson E, Bek T, Porta M, et al. Screening and prevention of diabetic blindness. Acta Ophth Scand. 2000;78:374–85.CrossRef
41.
go back to reference Thomas RL, Dunstan F, Luzio SD, et al. Incidence of diabetic retinopathy in people with type 2 diabetes mellitus attending the diabetic retinopathy screening services for wales: retrospective analysis. BMJ. 2012;344:e874.PubMedCrossRef Thomas RL, Dunstan F, Luzio SD, et al. Incidence of diabetic retinopathy in people with type 2 diabetes mellitus attending the diabetic retinopathy screening services for wales: retrospective analysis. BMJ. 2012;344:e874.PubMedCrossRef
42.
go back to reference Younis N, Broadbent DM, Vora JP, Harding SP. Incidence of sight-threatening retinopathy in patients with type 2 diabetes in the liverpool diabetic eye study: a cohort study. Lancet. 2003;361:195–200.PubMedCrossRef Younis N, Broadbent DM, Vora JP, Harding SP. Incidence of sight-threatening retinopathy in patients with type 2 diabetes in the liverpool diabetic eye study: a cohort study. Lancet. 2003;361:195–200.PubMedCrossRef
43.
go back to reference Olafsdottir E, Stefansson E. Biennial eye screening in patients with diabetes without retinopathy; 10-year experience. Br J Ophthalmol. 2008;91:1599–601.CrossRef Olafsdottir E, Stefansson E. Biennial eye screening in patients with diabetes without retinopathy; 10-year experience. Br J Ophthalmol. 2008;91:1599–601.CrossRef
44.
go back to reference Kohner EM, Stratton IM, Aldington SJ, et al. Relationship between the severity of retinopathy and progression to photocoagulation in patients with type 2 diabetes mellitus in the UKPDS (UKPDS 52). Diabet Med. 2001;18:178–84.PubMed Kohner EM, Stratton IM, Aldington SJ, et al. Relationship between the severity of retinopathy and progression to photocoagulation in patients with type 2 diabetes mellitus in the UKPDS (UKPDS 52). Diabet Med. 2001;18:178–84.PubMed
45.
go back to reference Vijan S, Hofer T, Hayward R. Cost-utility analysis of screening intervals for diabetic retinopathy in patients with type 2 diabetes mellitus. JAMA. 2000;283:889–96.PubMedCrossRef Vijan S, Hofer T, Hayward R. Cost-utility analysis of screening intervals for diabetic retinopathy in patients with type 2 diabetes mellitus. JAMA. 2000;283:889–96.PubMedCrossRef
46.
go back to reference Klein R, Klein BE, Moss SE, Cruickshanks KJ. The wisconsin epidemiologic study of diabetic retinopathy: XVII. The 14-year incidence and progression of diabetic retinopathy and associated risk factors in type 1 diabetes. Ophthalmology. 1998;105:1801–15.PubMedCrossRef Klein R, Klein BE, Moss SE, Cruickshanks KJ. The wisconsin epidemiologic study of diabetic retinopathy: XVII. The 14-year incidence and progression of diabetic retinopathy and associated risk factors in type 1 diabetes. Ophthalmology. 1998;105:1801–15.PubMedCrossRef
47.
go back to reference Lyons TJ, Jenkins AJ, Zheng D, et al. Diabetic retinopathy and serum lipoprotein substances in the DCCT/EDIC cohort. IOVS. 2004;45:910–8. Lyons TJ, Jenkins AJ, Zheng D, et al. Diabetic retinopathy and serum lipoprotein substances in the DCCT/EDIC cohort. IOVS. 2004;45:910–8.
48.
go back to reference UK Prospective Diabetes Study Group. Tight blood pressure control and risk of microvascular and macrovascular complications in type 2 diabetes: UKPDS 38. BMJ. 1998;317:703–13.CrossRef UK Prospective Diabetes Study Group. Tight blood pressure control and risk of microvascular and macrovascular complications in type 2 diabetes: UKPDS 38. BMJ. 1998;317:703–13.CrossRef
49.
go back to reference Stratton IM, Kohner EM, Aldington SJ, et al. UKPDS 50: risk factors for incidence and progression of diabetic retinopathy in type II diabetes over 6 years from diagnosis. Diabetologia. 2001;44:256–163.CrossRef Stratton IM, Kohner EM, Aldington SJ, et al. UKPDS 50: risk factors for incidence and progression of diabetic retinopathy in type II diabetes over 6 years from diagnosis. Diabetologia. 2001;44:256–163.CrossRef
50.
go back to reference Kristinsson JK. Diabetic retinopathy screening and prevention of blindness. A doctoral thesis. Acta Ophthalmol Scand Suppl. 1997;223:1–76.PubMed Kristinsson JK. Diabetic retinopathy screening and prevention of blindness. A doctoral thesis. Acta Ophthalmol Scand Suppl. 1997;223:1–76.PubMed
51.
go back to reference Aspelund T, Porisdottir O, Olafsdottir E, Gudmundsdottir A, Einarsdottir AB, et al. Individual risk assessment and information technology to optimize screening frequency for diabetic retinopathy. Diabetologia. 2011;54:2525–32.PubMedCrossRef Aspelund T, Porisdottir O, Olafsdottir E, Gudmundsdottir A, Einarsdottir AB, et al. Individual risk assessment and information technology to optimize screening frequency for diabetic retinopathy. Diabetologia. 2011;54:2525–32.PubMedCrossRef
52.
go back to reference Jones S, Edwards T. Diabetic retinopathy screening: a systematic review of the economic evidence. Diabet Med. 2010;27:249–56.PubMedCrossRef Jones S, Edwards T. Diabetic retinopathy screening: a systematic review of the economic evidence. Diabet Med. 2010;27:249–56.PubMedCrossRef
53.
go back to reference • Sivaprasad S, Gupta B, Gulliford M, Dodhia H, Mohamed M et al. Ethnic variations in the prevalence of diabetic retinopathy in people with diabetes attending screening in the United Kingdom (DRIVE UK). PloS One. 2012; 7(3):e32182. This paper is of importance to those who work in ethnically diverse communities. • Sivaprasad S, Gupta B, Gulliford M, Dodhia H, Mohamed M et al. Ethnic variations in the prevalence of diabetic retinopathy in people with diabetes attending screening in the United Kingdom (DRIVE UK). PloS One. 2012; 7(3):e32182. This paper is of importance to those who work in ethnically diverse communities.
54.
go back to reference Klein R, Sharrett AR, Klein BE, Moss SE, Folsom AR, et al. The association of atherosclerosis, vascular risk factors and retinopathy in adults with diabetes: the atherosclerosis risk in communities study. Ophthalmology. 2002;109:1225–34.PubMedCrossRef Klein R, Sharrett AR, Klein BE, Moss SE, Folsom AR, et al. The association of atherosclerosis, vascular risk factors and retinopathy in adults with diabetes: the atherosclerosis risk in communities study. Ophthalmology. 2002;109:1225–34.PubMedCrossRef
55.
go back to reference Wong TY, Klein R, Islam FM, Cotch MF, Folsom AR, et al. Diabetic retinopathy in a multi-ethnic cohort in the United States. Am J Ophthalmol. 2006;141:446–55.PubMedCrossRef Wong TY, Klein R, Islam FM, Cotch MF, Folsom AR, et al. Diabetic retinopathy in a multi-ethnic cohort in the United States. Am J Ophthalmol. 2006;141:446–55.PubMedCrossRef
56.
go back to reference • McGeechan K, Liew G, Macaskill P, et al. Prediction of incident stroke events based on retinal vessel caliber: a systematic review and individual-participant meta-analysis. Am J Epidemiol. 2009;170(11):1323–32. This paper is of importance as it is a well-conducted meta-analysis and contains all seminal papers in this field.PubMedCrossRef • McGeechan K, Liew G, Macaskill P, et al. Prediction of incident stroke events based on retinal vessel caliber: a systematic review and individual-participant meta-analysis. Am J Epidemiol. 2009;170(11):1323–32. This paper is of importance as it is a well-conducted meta-analysis and contains all seminal papers in this field.PubMedCrossRef
57.
go back to reference • Ong HS, Levin S, Vafidis G. Glaucoma detection using optic disc images from the English National Screening Programme for diabetic retinopathy. J Glaucoma 2012 Jan 20. [Epub ahead of print]. This paper can potentially influence how the screening imaging might be used for glaucoma screening as well. • Ong HS, Levin S, Vafidis G. Glaucoma detection using optic disc images from the English National Screening Programme for diabetic retinopathy. J Glaucoma 2012 Jan 20. [Epub ahead of print]. This paper can potentially influence how the screening imaging might be used for glaucoma screening as well.
58.
go back to reference • Hadley G, Earnshaw JJ, Stratton I, Sykes J, Scanlon PH. A potential pathway for managing diabetic patients with arterial emboli detected by retinal screening. Eur J Vasc Endovasc Surg. 2011;42(2):153–57. This paper is of importance as it shows how screening might influence patient pathway.PubMedCrossRef • Hadley G, Earnshaw JJ, Stratton I, Sykes J, Scanlon PH. A potential pathway for managing diabetic patients with arterial emboli detected by retinal screening. Eur J Vasc Endovasc Surg. 2011;42(2):153–57. This paper is of importance as it shows how screening might influence patient pathway.PubMedCrossRef
Metadata
Title
Screening for Diabetic Retinopathy and Diabetic Macular Edema in the United Kingdom
Authors
Tunde Peto
Christine Tadros
Publication date
01-08-2012
Publisher
Current Science Inc.
Published in
Current Diabetes Reports / Issue 4/2012
Print ISSN: 1534-4827
Electronic ISSN: 1539-0829
DOI
https://doi.org/10.1007/s11892-012-0285-4

Other articles of this Issue 4/2012

Current Diabetes Reports 4/2012 Go to the issue

Microvascular Complications—Nephropathy (B Roshan, Section Editor)

Glycemic Control in Diabetic Dialysis Patients and the Burnt-Out Diabetes Phenomenon

Microvascular Complications—Neuropathy (D Ziegler, Section Editor)

Prediabetic Neuropathy: Does It Exist?

Microvascular Complications—Retinopathy (JK Sun, Section Editor)

Neuroprotection in Diabetic Retinopathy

Microvascular Complications—Retinopathy (JK Sun, Section Editor)

Novel Targets Against Retinal Angiogenesis in Diabetic Retinopathy

Microvascular Complications—Nephropathy (B Roshan, Section Editor)

Anti-Fibrosis Therapy and Diabetic Nephropathy

Microvascular Complications—Neuropathy (D Ziegler, Section Editor)

Small Fiber Neuropathy: Is Skin Biopsy the Holy Grail?

Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.