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Drinkwater JJ, Kalantary A, Turner AW. A systematic review of diabetic retinopathy screening intervals. Acta Ophthalmol 2023. [PMID: 37915115 DOI: 10.1111/aos.15788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 09/26/2023] [Accepted: 09/28/2023] [Indexed: 11/03/2023]
Abstract
The current evidence on whether annual diabetic retinopathy (DR) screening intervals can be extended was reviewed. A systematic review protocol was followed (PROSPERO ID: CRD42022359590). Original longitudinal articles that specifically assessed DR screening intervals were in English and collected data after 2000 were included. Two reviewers independently conducted the search and reviewed the articles for quality and relevant information. The heterogeneity of the data meant that a meta-analysis was not appropriate. Twelve publications were included. Studies were of good quality and many used data from DR screening programs. Studies fit into three categories; those that assessed specific DR screening intervals, those that determined optimal DR screening intervals and those that developed/assessed DR screening risk equations. For those with type 2 diabetes, extending screening intervals to 3- to 4-yearly in those with no baseline DR appeared safe. DR risk equations considered clinical factors and allocated those at lower risk of DR progression screening intervals of up to five years. Those with baseline DR or type 1 diabetes appeared to have a higher risk of progression to STDR and needed more frequent screening. DR screening intervals can be extended to 3-5 yearly in certain circumstances. These include patients with type 2 diabetes and no current DR, and those who have optimal management of other risk factors such as glucose and blood pressure.
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Affiliation(s)
- Jocelyn J Drinkwater
- Center for Ophthalmology and Visual Science, The University of Western Australia, Nedlands, Western Australia, Australia
- Lions Outback Vision, Lions Eye Institute, Nedlands, Western Australia, Australia
| | - Amy Kalantary
- Lions Outback Vision, Lions Eye Institute, Nedlands, Western Australia, Australia
| | - Angus W Turner
- Center for Ophthalmology and Visual Science, The University of Western Australia, Nedlands, Western Australia, Australia
- Lions Outback Vision, Lions Eye Institute, Nedlands, Western Australia, Australia
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Creuzot-Garcher C, Massin P, Srour M, Baudin F, Dot C, Nghiem-Buffet S, Girmens JF, Collin C, Ponthieux A, Delcourt C. Epidemiology of Treated Diabetes Ocular Complications in France 2008-2018-The LANDSCAPE French Nationwide Study. Pharmaceutics 2022; 14:2330. [PMID: 36365148 PMCID: PMC9697089 DOI: 10.3390/pharmaceutics14112330] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 10/17/2022] [Accepted: 10/27/2022] [Indexed: 01/27/2024] Open
Abstract
AIM LANDSCAPE aimed to estimate the annual incidence and prevalence of treated diabetic macular edema (DME) and proliferative diabetic retinopathy (PDR) between 2008 and 2018. METHODS This French nationwide observational study used data from the French National Health Insurance Databases covering 99% of the French population. Data about healthcare consumption were used to identify adults treated with anti-VEGFs or dexamethasone implants (for DME) and with pan-retinal photocoagulation (for PDR). All French patients newly treated between 2008 and 2018 were included. Incidence and prevalence of treated DME and PDR were estimated for the age-matched general population and the population with diabetes in France. Sociodemographic characteristics and medical history were described in both populations. RESULTS We identified 53,584 treated DME patients and 127,273 treated PDR patients between 2008 and 2018, and 11,901 DME and 11,996 PDR new incident patients in 2018. The treated DME incidence in 2018 was 2.5 per 10,000 in the general population and 37.3 per 10,000 in the population with diabetes. Prevalence in 2018 was 9.5 and 143.7 per 10,000 in the respective populations. Treated PDR incidence in 2018 was 2.3 per 10,000 in the general population and 31.2 per 10,000 in the population with diabetes. Prevalence in 2018 was 19.9 and 270.3 per 10,000 in the respective populations. Incidence and prevalence were not age-dependent. Incidence of treated PDR incidence was relatively stable from 2008-2018. Incidence of treated DME incidence rose from 2012-2018, probably due to widening access to newly available treatments, such as anti-VEGFs. CONCLUSIONS We provide exhaustive nationwide data on the incidence and prevalence of treated diabetic ocular complications in France over a 10-year period.
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Affiliation(s)
| | - Pascale Massin
- Cabinet d’Ophtalmologie de Breteuil, Centre Broca, Hôpital Lariboisière, 75013 Paris, France
| | - Mayer Srour
- Department of Ophthalmology, Centre Hospitalier Intercommunal de Créteil, Université de Paris Est Créteil, 94000 Créteil, France
| | - Florian Baudin
- Department of Ophthalmology, University Hospital, 21000 Dijon, France
| | - Corinne Dot
- Department of Ophthalmology, Desgenettes Military Hospital, 69003 Lyon, France
| | | | - Jean-Francois Girmens
- Department of Ophthalmology, INSERM-DGOS CIC 1423, Centre Hospitalier National d’Ophtalmologie (CHNO) des Quinze-Vingts, 75012 Paris, France
| | | | - Anne Ponthieux
- Novartis Pharma SAS, 8/10 rue Henri Sainte Claire Deville, 92563 Rueil-Malmaison, France
| | - Cecile Delcourt
- Team LEHA, Bordeaux Population Health Research Center, UMR 1219, Institut National de la Santé et de la Recherche Médicale (Inserm), University of Bordeaux, 33000 Bordeaux, France
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Hill S, Mullins P, Murphy R, Schmiedel O, Vaghefi E, Ramke J, Squirrell D. Risk Factors for Progression to Referable Diabetic Eye Disease in People With Diabetes Mellitus in Auckland, New Zealand: A 12-Year Retrospective Cohort Analysis. Asia Pac J Ophthalmol (Phila) 2021; 10:579-589. [PMID: 34905518 DOI: 10.1097/apo.0000000000000464] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
PURPOSE To evaluate the prevalence and risk factors for the development of any and referable diabetic eye disease in a multi-ethnic New Zealand population with diabetes mellitus attending a regional retinal screening service. METHODS Retrospective observational cohort study of people living with diabetes who attended the Auckland Regional Diabetic Retinal Screening Programme 2006-2018 inclusive (n = 41,786). RESULTS Any retinopathy/maculopathy was present at first screening for 48.2% [95% confidence interval (CI): 45.8%-50.6%] / 37.8% (95% CI: 35.5%- 40.1%) of people with Type 1 and 25% (95% CI: 24.6%-25.4%) / 21.9% (95% CI: 21.5%-22.3%) with Type 2 diabetes. Referable retinopathy at baseline screening was 4.4% (95% CI: 3.6%-5.3%) and 1.6% (95% CI: 1.5%-1.7%) among people with Type 1 and Type 2 diabetes mellitus, respectively. After 4 years, cumulative incidence for referable retinopathy /referable maculopathy was 12/36 per 1000 people with Type 1 and 2.4/16 per 1000 people with Type 2 diabetes. Independent hazards for disease progression varied for the diabetes cohort types but baseline grade, duration of diabetes, and HbA1c were common to all. CONCLUSIONS Referable diabetic eye disease at the first screening and after 4 years of follow-up is uncommon. Lengthening of the screening intervals for people with no or mild diabetic eye disease at first screening assessment could be considered.
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Affiliation(s)
- Sophie Hill
- Ophthalmology Department, Auckland District Health Board, 214 Green Lane West, One Tree Hill, Epsom, Auckland 105, New Zealand
- Ophthalmology Department, University of Auckland, Grafton, Auckland 1023, New Zealand
| | - Peter Mullins
- Department of Statistics, University of Auckland, Faculty of Science, Science Centre 3030, Auckland 1010, New Zealand
| | - Rinki Murphy
- Ophthalmology Department, Auckland District Health Board, 214 Green Lane West, One Tree Hill, Epsom, Auckland 105, New Zealand
- Department of Medicine, University of Auckland, Building 507, Grafton, Auckland 1023, New Zealand
| | - Ole Schmiedel
- Ophthalmology Department, Auckland District Health Board, 214 Green Lane West, One Tree Hill, Epsom, Auckland 105, New Zealand
| | - Ehsan Vaghefi
- School of Optometry and Vision Science, University of Auckland, Grafton, Auckland 1023, New Zealand
| | - Jacqueline Ramke
- School of Optometry and Vision Science, University of Auckland, Grafton, Auckland 1023, New Zealand
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, Keppel Street, London WC1E 7HT, United Kingdom
| | - David Squirrell
- Ophthalmology Department, Auckland District Health Board, 214 Green Lane West, One Tree Hill, Epsom, Auckland 105, New Zealand
- Ophthalmology Department, University of Auckland, Grafton, Auckland 1023, New Zealand
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Zureik A, Julla JB, Erginay A, Vidal-Trecan T, Juddoo V, Gautier JF, Massin P, Tadayoni R, Riveline JP, Couturier A. Prevalence, severity stages, and risk factors of diabetic retinopathy in 1464 adult patients with type 1 diabetes. Graefes Arch Clin Exp Ophthalmol 2021; 259:3613-3623. [PMID: 34264396 DOI: 10.1007/s00417-021-05298-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 06/21/2021] [Accepted: 06/22/2021] [Indexed: 12/16/2022] Open
Abstract
PURPOSE To determine the prevalence of diabetic retinopathy (DR) and its risk factors in adult type 1 diabetes (T1D) patients METHODS: In this cross-sectional study, all T1D patients followed in the University Center for Diabetes and its Complications of Lariboisière Hospital (Paris, France) between January 2017 and February 2019 were included. Ophthalmologic and systemic data were collected from electronic records. The association between DR (and each grade) and associated factors were estimated by univariate and multivariate analyses using logistic regression models. RESULTS A total of 1464 patients (46.2% of women, mean age: 42.2 ± 15.8 years) were included. The mean hemoglobin A1c (HbA1c) was 7.8 ± 1.7% and the mean diabetes duration was 20.5 ± 13.5 years. DR prevalence was 50.1% (47.4-52.6) and the prevalence of mild, moderate, and severe non-proliferative DR and proliferative DR was 19.1%, 9.4%, 3.9%, and 17.6%, respectively. DR was significantly associated with male gender, an older age, former and current smoking status, a higher BMI, the presence of nephropathy and neuropathy, higher HBA1c, and longer diabetes duration. Patients with HbA1c > 10% had an adjusted odds ratio (OR) of 3.25 (1.77-6.01) of having DR compared to patients with HbA1c < 6.5%. Patients with a diabetes duration > 30 years had an adjusted OR of 24.87 (14.82-42.67) higher of having DR compared to patients with a diabetes duration < 10 years. CONCLUSION In this study, 50.1% of adult T1D patients had DR and 17.6% had proliferative DR. Diabetes duration and HbA1c were major risk factors.
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Affiliation(s)
- Abir Zureik
- University of Paris, Ophthalmology Department, AP-HP, Lariboisière Hospital, F-75010, Paris, France.
| | - Jean-Baptiste Julla
- Department of Diabetology and Endocrinology, Lariboisière Hospital, AP-HP, 2 rue Ambroise Paré, Paris, France. Unité INSERM U1138 Immunity and Metabolism in Diabetes, ImMeDiab Team, Centre de Recherches des Cordeliers, Paris, France. Université de Paris, Paris, France
| | - Ali Erginay
- University of Paris, Ophthalmology Department, AP-HP, Lariboisière Hospital, F-75010, Paris, France
| | - Tiphaine Vidal-Trecan
- Department of Diabetology and Endocrinology, Lariboisière Hospital, AP-HP, 2 rue Ambroise Paré, Paris, France. Unité INSERM U1138 Immunity and Metabolism in Diabetes, ImMeDiab Team, Centre de Recherches des Cordeliers, Paris, France. Université de Paris, Paris, France
| | - Vanessa Juddoo
- Department of Diabetology and Endocrinology, Lariboisière Hospital, AP-HP, 2 rue Ambroise Paré, Paris, France. Unité INSERM U1138 Immunity and Metabolism in Diabetes, ImMeDiab Team, Centre de Recherches des Cordeliers, Paris, France. Université de Paris, Paris, France
| | - Jean-François Gautier
- Department of Diabetology and Endocrinology, Lariboisière Hospital, AP-HP, 2 rue Ambroise Paré, Paris, France. Unité INSERM U1138 Immunity and Metabolism in Diabetes, ImMeDiab Team, Centre de Recherches des Cordeliers, Paris, France. Université de Paris, Paris, France
| | - Pascale Massin
- University of Paris, Ophthalmology Department, AP-HP, Lariboisière Hospital, F-75010, Paris, France
| | - Ramin Tadayoni
- University of Paris, Ophthalmology Department, AP-HP, Lariboisière Hospital, F-75010, Paris, France
| | - Jean-Pierre Riveline
- Department of Diabetology and Endocrinology, Lariboisière Hospital, AP-HP, 2 rue Ambroise Paré, Paris, France. Unité INSERM U1138 Immunity and Metabolism in Diabetes, ImMeDiab Team, Centre de Recherches des Cordeliers, Paris, France. Université de Paris, Paris, France
| | - Aude Couturier
- University of Paris, Ophthalmology Department, AP-HP, Lariboisière Hospital, F-75010, Paris, France.
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