UK National Screening Committee revises guidelines on diabetic retinopathy screening

Kurt Wood
Tue, 19 Jan 2016
UK National Screening Committee revises guidelines on diabetic retinopathy screening
The UK National Screening Committee (NSC) is working towards revising the recommendations concerning screening intervals for diabetic retinopathy.

The organisation, which advises the NHS and government ministers in the UK, has agreed to a further evaluation of whether people with diabetes who are at a low risk of sight loss can be screened for retinopathy every two years, rather than annually. For those people who are clinically evaluated as having a high risk of sight loss, the guidelines for retinopathy screening are unchanged..

These pending changes to retinopathy screening guidelines are one of a number of revisions conducted by the UK NCS. Other conditions under review are bowel cancer, cervical cancer and glaucoma, which can be a complication of diabetes.

"Following a review of the evidence against strict criteria, the UK NSC recommended that the interval between screening tests should change from one year to two years for people with diabetes at low risk of sight loss," said the UK NSC's recommendation statement.

Why has the UK NSC changed the screening guidelines for diabetic retinopathy?

The UK NSC has changed the screening guidelines for diabetic retinopathy in response to a recent study which found that, in people with diabetes at low risk of sight loss, one screening every two years is adequate.

"Following two successive clear diabetic eye screening appointments people with diabetes will be classed as being at low risk of developing sight-threatening retinopathy," says the UK NSC screening guidelines for diabetic retinopathy.

"A large observational study was carried out which showed that it was safe to invite people in this low risk group every two years rather than annually. Screening this group less often not only releases capacity, but also lessens the inconvenience for this group of attending appointments every year."

Screening intervals for people with diabetes whom clinicians consider as a high risk of sight loss are unchanged, because "the study found that the current screening interval for people with a high risk of sight loss should remain annual."

Glaucoma screening recommendations

Glaucoma is a disease of the eye that occurs when fluid builds up against the nerve at the back of the eye. It can be a complication of diabetes that occurs alongside diabetic retinopathy.

The UK NSC does not recommend a screening process for glaucoma, because "there are no tests which can accurately predict who is going to develop the disease [...] many people diagnosed with early glaucoma will never suffer visual impairment in their lifetime [...] there isn't any good-quality evidence that demonstrates treatment to be better than no treatment [...] [and because] the effectiveness of a screening programme has not be studied; therefore there is no evidence to suggest that a programme would reduce the burden of the disease to the UK population."
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