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Practical community screening for diabetic retinopathy using the mobile retinal camera: report of a 12 centre study.
1Royal Victoria Infirmary, Newcastle upon Tyne.
Objective:
To document the performance of 12 diabetes eye screening units in different health districts which were financed by a single charitable donation.
Design:
Each location was equipped with a retinal camera and screening vehicle, and the lead clinician developed the screening service configuration to suit local conditions.
Settings:
Districts were chosen on the basis of interest in developing effective diabetes eye screening services. Characteristics of districts varied from largely rural to exclusively urban.
Subjects:
People with diabetes who attended either general practice or hospital diabetes services were screened.
Main Outcome Measures:
Referral for ophthalmological opinion and use of laser therapy for new vessel formation or exudative maculopathy.
Results:
A total of 64,905 screening episodes were recorded. Full data were available on 42,803 episodes which led to 2400 referrals (5.6%) and 516 of which resulted in laser therapy (1.2% of those screened or 21.5% of those referred). Where sequential data were available a year by year fall in sight threatening retinopathy incidence was demonstrated as the screening programmes detected incipient problems in the initial cycles of screening. The average cost of screening was Pounds13.11 per patient and the average cost of identifying a person requiring laser therapy was Pounds1110. Financial responsibility for running the service has been taken on by 10 of the 12 health districts.
Conclusions:
Diabetes eye screening using a mobile retinal camera is effective, efficient and robust. It is important that the service specification is designed to suit the geography and existing diabetes services in each district.