Eyes on the Prize: Studying the Frequency of Eye Exams for Patients With Differing Retinopathy Risks
What to Know
Diabetic retinopathy, an eye disease that can lead to blindness, can be prevented by controlling blood glucose and blood pressure. Regular eye exams can help to ensure that mild disease is found early and treated before it becomes more serious. Current guidelines recommend that all diabetes patients receive annual eye exams after their first eye exam following their diabetes diagnosis. However, this eye disease moves slowly, so an exam every two years may be all that’s necessary. The authors of this study wanted to determine the ideal interval between exams.
The researchers reviewed the health records of 354,549 patients who had had eye screening exams in the U.K. between 2005 and 2012. Patients who had either no eye disease or only mild diabetic retinopathy were followed for up to four years to find out whether and when they progressed to more serious eye disease.
About 5 percent of the patients progressed to moderate or worse retinopathy during the study period. Of the patients who started with no retinopathy in either eye for two consecutive annual exams, as many as 1.3 percent progressed to moderate or worse retinopathy and less than 0.3 percent progressed to more severe retinopathy after two years. Of those who started with mild retinopathy in both eyes, 13 to 29 percent progressed to moderate or worse retinopathy and up to 4 percent progressed to severe retinopathy.
Based on this research, people with low risk for diabetic retinopathy may need an eye exam only every two years, whereas those with high risk could benefit from an exam twice a year. Those with moderate risk likely should get an eye exam every year. Such a plan could reduce the burden on patients and save on health care costs. The researchers recommend a future study that compares a large number of people who received annual eye exams to equal numbers of people who got eye exams more or less often according to their risk level.
Progression of diabetes retinal status within community screening programs and potential implications for screening intervals, by Leese and colleagues. Diabetes Care 2015;38:488–494 https://doi.org/10.2337/dc14-1778