An evaluation of a surveillance clinic with two fields digital photography for those who present with early signs of referable diabetic maculopathy over a 4 year follow up period

The NHS Diabetic Eye Screening Programme states that from April 2013 all programmes should provide a virtual photographic clinic in order to reduce the number of unnecessary referrals into the Hospital Eye Service. The aim of the audit is to evaluate the surveillance clinic pathway as a means to manage […]

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Is arbitration of all abnormal grades valuable in retinopathy grading quality assurance?

Our local diabetic eye screening programme assesses images sets using the English National Grading Protocol. All sets (primary) graded abnormal are quality assurance (secondary) graded ‘blind’. Disagreements are arbitrated. The patient is then either returned to annual screening or referred to an ophthalmology gatekeeper. In October 2010 we stopped arbitrating […]

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What is the prevalence of diabetic macular oedema involving the centre of the macula in patients undergoing digital diabetic retinopathy screening?

Macular oedema can lead to severe visual loss especially if the the centre of the macula; the fovea is involved. Intravitreal therapies are becoming increasingly popular in the treatment of centre involving diabetic macular oedema (CIDMO). The aim of the audit was to assess the prevalence of CIDMO in the […]

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Ophthalmic Photographic Diabetic Review (OPDR): a virtual clinic approach for management of referable diabetic maculopathy

Digital diabetic eye screening has caused an increase in referrals to hospital eye services creating capacity problems. An additional patient pathway was devised and incorporated into the screening software so patients with early maculopathy cold be cared for in a virtual manner. The aim of the audit was to assess […]

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Inadequate images in the Birmingham, Solihull and Black Country Diabetic Eye Screening programme

Since the introduction of the English National Screening Programme for Diabetic Retinopathy (ENSPDR), there has been a dramatic increase in the number of referrals to HES for other lesions, especially cataracts. Patients with unassessable images cannot be assigned a grade, and this presents a problem for the screening services. ENSPDR […]

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Follow up report on diabetic patients identified with macula lesions to review their current clinical status and the change in the morphological features of the lesions

A number of patients have been identified at screening as having subtle changes within the macula region, the significance of which is unknown Tiny microaneurysms are common but on magnification, a number demonstrate a yellow circular rim (MAYR) which could represent early lipid leakage which could lead to sight threatening […]

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Is it safe to increase diabetic retinopathy screening intervals in patients with no background diabetic retinopathy?

Guidelines set by The English National Screening Programme for Diabetic Retinopathy (ENSPDR) state that all patients with diabetes should be screened annually for diabetic retinopathy. With the number of people being diagnosed with diabetes in the population ever increasing, screening programmes may find it difficult to reach screening targets set by ENSPDR. However, it has been proposed that it is safe to screen patients who present with no diabetic retinopathy at longer intervals of two or three years. Read more

Macular thickness in diabetic pregnant women throughout their pregnancy

There is an increased risk of sight threatening diabetic retinopathy in pregnant women thought to be due to poor glycaemic control before pregnancy with tight glycaemic control in early pregnancy, other factors include hypertension, neuropathy and preecamplsia. The NICE guidelines state that all women with pre-existing diabetes should be offered […]

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Patients who present with optic disc haemorrhages at diabetic retinopathy screening

Diabetic retinopathy screening presents itself as an opportunity to identify other eye conditions. This includes Glaucoma. One of the features of Glaucoma is optic disc haemorrhages which can be easily identified in retinal photos. Some optic disc haemorrhages can be due to DR, medication or valsalva (constipation, strenuous exercise, coughing). […]

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Is there variability in visual acuity of patients with maculopathy recorded in the digital diabetic retinopathy screening service compared to the hospital eye service?

To determine whether visual acuity (VA) is reliable and reproducible between screening and the hospital eye service. this is particularly important to those with referable maculopathy defined by macular haemorrhages/microaneurysms within one optic disc diameter with best corrected visual acuity >6/9, in the English Diabetic Eye Screening Programme. View Abstract […]

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Management and Outcome of Venous and Arterial Occlusions Identified in a Diabetic Retinopathy Screening Programme – A retrospective Audit

Diabetic retinopathy screening allows for opportunistic identification of other lesions, a common example are venous and arterial occlusions. Occlusions may affect the whole of the retina (central) or just part of the retina (branch). If the occlusion involves the central retinal vision may be affected. There are a number of […]

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Screening for diabetic retinopathy in pregnancy using photographic review clinics

Many factors influence the progression of diabetic retinopathy in pregnancy, which leaves pregnant patients in a high risk group and needing to be screened more frequently. Most screening programmes screen pregnant patients in hospital eye clinics throughout pregnancy. This audit looks at the efficacy of NICE guidelines 2008 within a […]

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Proliferative diabetic retinopathy (R3) referrals from the digital diabetic retinopathy screening program: Urgency of appointment in the hospital eye service achieved and needed?

The English National Screening Programme has set standards regarding referral patients who present with proliferative diabetic retinopathy at screening. These standards include: A minimum standard of 60% <2 weeks and 95% <4 weeks for time between notification of positive test and consultation. A minimum standard of 90% <2 weeks for […]

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Management and Outcome of Cholesterol Embolus Identified in a Diabetic Retinopathy Screening Programme – A retrospective audit

Diabetic retinopathy screening allows for opportunistic identification of other lesions, an example of which is cholesterol embolus. Cholesterol emboli are associated with an increased risk of stroke therefore it is important that patients who present with them are managed in an appropriate way. Different screening programmes have local policies in […]

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How accurate are photographic surrogate markers used to detect macular oedema in the English National Screening Programme?

Early findings suggest that only 10% of patients with screen positive maculopathy require laser treatment. This suggests poor specificity of photographic surrogate markers which are used to predict the presence of clinically significant macular oedema. The purpose of the audit is to determine how many patients who present with macular […]

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