Trends in diabetic retinopathy screening attendance and associations with vision impairment attributable to diabetes in a large nationwide cohort
Trends in diabetic retinopathy screening attendance and associations with vision impairment attributable to diabetes in a large nationwide cohort
Aims: to investigate diabetic retinopathy screening attendance and trends in certified vision impairment caused by diabetic eye disease.
Methods: this was a retrospective study of attendance in three urban UK diabetic eye screening programmes in England. A survival analysis was performed to investigate time from diagnosis to first screen by age and sex. Logistic regression analysis of factors influencing screening attendance during a 15-month reporting period was conducted, as well as analysis of new vision impairment certifications (Certificate of Vision Impairment) in England and Wales from 2009 to 2019.
Results: of those newly registered in the Routine Digital Screening pathway (n = 97 048), 80% attended screening within the first 12 months and 88% by 36 months. Time from registration to first eye screening was longer for people aged 18–34 years, and 20% were unscreened after 3 years. Delay in first screen was associated with increased risk of referable retinopathy. Although 95% of participants (n = 291 296) attended during the 15-month reporting period, uptake varied considerably. Younger age, social deprivation, ethnicity and duration of diabetes were independent predictors of non-attendance and referable retinopathy. Although the last 10 years has seen an overall reduction in vision impairment certification attributable to diabetic eye disease, the incidence of vision impairment in those aged <35 years was unchanged.
Conclusions: whilst the majority of participants are screened in a timely manner, there is considerable variation in uptake. Young adults, have sub-optimal attendance, and levels of vision impairment in this population have not changed over the last 10 years. There is an urgent need to explore barriers to/enablers of attendance in this group to inform policy initiatives and tailored interventions to address this issue.
Lawrenson, J.G.
dd8f2a29-5839-4651-8108-84e72387528b
Bourmpaki, E.
72c42db9-e03e-417b-b7ee-891de1b29102
Bunce, C.
579f2c2a-5583-49b7-bb0d-7a80d3ae8867
Stratton, I.M.
772f25b9-23c0-4240-a3f6-1e76b03b172f
Gardner, P.
e79a31d6-79f3-4b81-8a4a-badb4358bc91
Anderson, J.
717a1450-3122-4f61-8e1c-5a1fbc781712
Prothero, Louise
28b84de4-ef30-43ec-9097-589615ba5281
Cartwright, Martin
4ebf65eb-c627-41f7-8c53-4f544011c91c
Lorencatto, Fabiana
684e60d4-e926-4758-8cbc-b3b267c15759
Burr, Jennifer
839aa0b6-6263-4a6b-8fb6-669838ebdd6d
Peto, Tunde
e5511bbd-2ef8-4465-a2b3-46c8cc3ce63e
Gulliford, Martin
f6866310-c305-464b-92e2-e69bed8d55ef
Grimshaw, Jeremy
6e58b208-6dbd-4a33-b034-0f2a38b5e375
Presseau, Justin
6fd2d49d-ae3d-4156-aaef-60ca595511d0
Ivers, Noah
4e225f10-5312-477c-9fed-19146296e81a
19 March 2021
Lawrenson, J.G.
dd8f2a29-5839-4651-8108-84e72387528b
Bourmpaki, E.
72c42db9-e03e-417b-b7ee-891de1b29102
Bunce, C.
579f2c2a-5583-49b7-bb0d-7a80d3ae8867
Stratton, I.M.
772f25b9-23c0-4240-a3f6-1e76b03b172f
Gardner, P.
e79a31d6-79f3-4b81-8a4a-badb4358bc91
Anderson, J.
717a1450-3122-4f61-8e1c-5a1fbc781712
Prothero, Louise
28b84de4-ef30-43ec-9097-589615ba5281
Cartwright, Martin
4ebf65eb-c627-41f7-8c53-4f544011c91c
Lorencatto, Fabiana
684e60d4-e926-4758-8cbc-b3b267c15759
Burr, Jennifer
839aa0b6-6263-4a6b-8fb6-669838ebdd6d
Peto, Tunde
e5511bbd-2ef8-4465-a2b3-46c8cc3ce63e
Gulliford, Martin
f6866310-c305-464b-92e2-e69bed8d55ef
Grimshaw, Jeremy
6e58b208-6dbd-4a33-b034-0f2a38b5e375
Presseau, Justin
6fd2d49d-ae3d-4156-aaef-60ca595511d0
Ivers, Noah
4e225f10-5312-477c-9fed-19146296e81a
Lawrenson, J.G., Bourmpaki, E., Bunce, C., Stratton, I.M. and Gardner, P.
,
EROS Study Group
(2021)
Trends in diabetic retinopathy screening attendance and associations with vision impairment attributable to diabetes in a large nationwide cohort.
Diabetic Medicine, 38 (4), [e14425].
(doi:10.1111/dme.14425).
Abstract
Aims: to investigate diabetic retinopathy screening attendance and trends in certified vision impairment caused by diabetic eye disease.
Methods: this was a retrospective study of attendance in three urban UK diabetic eye screening programmes in England. A survival analysis was performed to investigate time from diagnosis to first screen by age and sex. Logistic regression analysis of factors influencing screening attendance during a 15-month reporting period was conducted, as well as analysis of new vision impairment certifications (Certificate of Vision Impairment) in England and Wales from 2009 to 2019.
Results: of those newly registered in the Routine Digital Screening pathway (n = 97 048), 80% attended screening within the first 12 months and 88% by 36 months. Time from registration to first eye screening was longer for people aged 18–34 years, and 20% were unscreened after 3 years. Delay in first screen was associated with increased risk of referable retinopathy. Although 95% of participants (n = 291 296) attended during the 15-month reporting period, uptake varied considerably. Younger age, social deprivation, ethnicity and duration of diabetes were independent predictors of non-attendance and referable retinopathy. Although the last 10 years has seen an overall reduction in vision impairment certification attributable to diabetic eye disease, the incidence of vision impairment in those aged <35 years was unchanged.
Conclusions: whilst the majority of participants are screened in a timely manner, there is considerable variation in uptake. Young adults, have sub-optimal attendance, and levels of vision impairment in this population have not changed over the last 10 years. There is an urgent need to explore barriers to/enablers of attendance in this group to inform policy initiatives and tailored interventions to address this issue.
Text
Diabetic Medicine - 2020 - Lawrenson - Trends in diabetic retinopathy screening attendance and associations with vision
- Version of Record
More information
Accepted/In Press date: 13 October 2020
e-pub ahead of print date: 1 November 2020
Published date: 19 March 2021
Additional Information:
Funding Information:
The authors would like to acknowledge the following: Ryan Chambers, Data Manager, North East London DESP; Laura Webster, Data Manager, South East London DESP; Alain du Chemin, Programme Manager, South East London DESP; Andrew Mills, Data Manager, Birmingham and Black Country DESP; Paul Galsworthy, Joint Programme & Grading Centre Manager, Birmingham & Black Country DESP; Helen Wharton, Senior Diabetic Retinopathy Screener/Grader, Birmingham & Black Country DESP; Antra Zekite and Declan Flanagan (Moorfields Eye Hospital). The data captured by the Certificate of Vision Impairment and Certificate of Visual Impairment Wales are the copyright of the Department of Health and Social Care and the Welsh Government respectively, and this work was made possible through a collaboration with the Royal College of Ophthalmologists.
Identifiers
Local EPrints ID: 487000
URI: http://eprints.soton.ac.uk/id/eprint/487000
ISSN: 0742-3071
PURE UUID: ea92f7be-261f-457b-9056-aeb10a159379
Catalogue record
Date deposited: 09 Feb 2024 17:37
Last modified: 18 Mar 2024 04:01
Export record
Altmetrics
Contributors
Author:
J.G. Lawrenson
Author:
E. Bourmpaki
Author:
C. Bunce
Author:
I.M. Stratton
Author:
P. Gardner
Author:
J. Anderson
Author:
Louise Prothero
Author:
Martin Cartwright
Author:
Fabiana Lorencatto
Author:
Jennifer Burr
Author:
Tunde Peto
Author:
Martin Gulliford
Author:
Jeremy Grimshaw
Author:
Justin Presseau
Author:
Noah Ivers
Corporate Author: EROS Study Group
Download statistics
Downloads from ePrints over the past year. Other digital versions may also be available to download e.g. from the publisher's website.
View more statistics