title: Implementation of national diabetes retinal screening programme is associated with a lower proportion of patients referred to ophthalmology.
abstract: OBJECTIVE
  To examine the impact of a new national retinal screening programme on screening attendance, technical quality of images, and referrals to the ophthalmology clinic.
  
  
  METHODS
  Results from the previous ad hoc retinal screening service were compared with data from the first year of the new Scottish Diabetes Retinal Screening Programme in Dundee, which was administered according to criteria recommended by the Health Technology Board Scotland.
  
  
  RESULTS
  Of 5150 patients invited for screening, 10.3% of patients did not attend. Overall, 4574 patients underwent single-field digital retinal photography and 25.4% required mydriasis for an adequate image. After screening, 1.9 and 90.5% were recalled for repeat photography at 6 months and 1 year, respectively, whilst 4.6% were ungradable and 3.0% were referred to the ophthalmology clinic. Compared with the last 18 months of the previous scheme, with the new programme a smaller proportion of patients were referred to ophthalmology (3.0 vs. 5.9%; P < 0.001, difference 2.9%: 95% confidence interval 2.1-3.7%). Moreover, the attendance was higher (89 vs. 82%; P < 0.01) and there were fewer ungradable images (4.6 vs. 7.1%; P < 0.001).
  
  
  CONCLUSIONS
  Introduction of a systematic retinal screening programme can reduce the proportion of patients referred to the ophthalmology clinic, and use ophthalmology services more efficiently.
authors: Ninewells Hospital, Dundee, UK. graham.leese@tuht.scot.nhs.uk
authors: G P
authors: GP
authors: Leese
authors: A D
authors: AD
authors: Morris
authors: K
authors: K
authors: Swaminathan
authors: J R
authors: JR
authors: Petrie
authors: R
authors: R
authors: Sinharay
authors: A
authors: A
authors: Ellingford
authors: A
authors: A
authors: Taylor
authors: R T
authors: RT
authors: Jung
authors: R W
authors: RW
authors: Newton
authors: J D
authors: JD
authors: Ellis
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003930:Diabetic Retinopathy / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods* / Q000592:standards; D008875:Middle Aged; D009885:Ophthalmology / Q000458:organization & administration; D010781:Photography / Q000592:standards; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D012606:Scotland; D015351:Vision Screening / Q000379:methods*