Progression of diabetic maculopathy in patients on the Wellington Diabetic Screening Programme initially graded M3

To determine the likelihood of progression from M3 grade maculopathy, and therefore the safety of these patients remaining under the care of a primary screener.

Patients graded M3 at diabetic screening were selected from the Wellington screening database. Photographs for this visit and the subsequent visit were obtained, and graded by a consultant ophthalmologist. Photographs graded M3 were included and progression of maculopathy between visits, number of patients with a reduction in vision and duration between visits were determined.

Mean duration between visits for all patients was 255 (plus or minus 59.5) days. Of the 54 eyes studied, 15 or 33.3% progressed to M4 maculopathy at the subsequent visit. Despite progressing from M3 to M4, none had a reduction of vision by more than one line of Snellen acuity at follow up due to diabetic maculopathy.

Rates of progression of maculopathy from M3 to M4 were of clinical significance. Despite this none had worsening visual acuity due to diabetic eye disease. This suggests patients with M3 maculopathy could be maintained under a primary screening programme, as is the case in the United Kingdom.