Screening for diabetic retinopathy: new perspectives and challenges

Area of Science:

• Ophthalmology
• Public Health
• Medical Technology

Background:

• Global diabetic retinopathy (DR) prevalence is rising, particularly type 2 diabetes in low- and middle-income countries, leading to increased visual impairment.
• Despite declining DR rates in some populations, worldwide visual impairment and blindness from DR increased between 1990 and 2015.
• Effective screening for DR is crucial for timely intervention to prevent irreversible vision loss.

Purpose of the Study:

• To review current diabetic retinopathy screening strategies and emerging technologies.
• To assess the cost-effectiveness and potential expansion of DR screening.
• To highlight the role of new technologies in improving DR detection and management.

Main Methods:

• Review of recent advancements in screening technologies for diabetic retinopathy.
• Analysis of personalized screening intervals and their cost-effectiveness.
• Exploration of teleophthalmology and artificial intelligence applications in DR detection.

Main Results:

• New technologies like ultrawide field imaging, teleophthalmology, and AI are enhancing DR screening efficiency and cost-effectiveness.
• Personalized screening intervals show promise but face resource limitations in nationwide programs.
• Retinal imaging may offer broader applications in identifying risks for cardiovascular disease and cognitive impairment.

Conclusions:

• Technological innovations are transforming diabetic retinopathy screening, improving accessibility and outcomes.
• Expanding screening beyond vision preservation to include systemic health markers is a promising future direction.
• Addressing resource scarcity is key to implementing effective nationwide DR screening programs.