Fewer eye exams, better eye health?

Customising the frequency of type 1 diabetes eye screening based on retinopathy levels could reduce costs and aid early detection, according to new research.

A study published in the New England Journal of Medicine found that adjusting screening frequency based on retinopathy severity could lead to the detection of severe retinopathy two to three months earlier, while also reducing the total number of eye examinations.

In the United States, type 1 diabetes patients begin to have annual eye examinations three to five years following diagnosis. The research outlined how adjusting screening frequency according to eye disease severity could result in an average of eight eye examinations over a 20-year period.

Dr Catherine Cowie, of the National Institute of Diabetes and Digestive and Kidney Diseases, told OT that annual retinal exams were costly and time-consuming for type 1 diabetes patients and ophthalmologists.

“The optimal frequency of eye exams may vary in people with type 1 diabetes. An individualised schedule may better fit the needs of type 1 diabetes patients and the availability of health professionals who treat them,” she explained.

Researchers estimated that reducing the overall frequency of eye examinations could lower screening costs by about $1bn (£773,800,000) over 20 years.

For people with type 1 diabetes and an average blood glucose level of 6%, researchers recommended eye examinations every four years for those with no retinopathy, every three years for patients with mild retinopathy and every six months for those with moderate retinopathy. For patients with severe retinopathy, researchers suggested eye examinations every three months.

Dr Cowie emphasised that the research findings would need further review before they could be incorporated into guidelines on the care of people with type 1 diabetes.

Further research would also be needed to determine whether the recommendations might also apply to those with type 2 diabetes.