title: Rates of referable eye disease in the Scottish National Diabetic Retinopathy Screening Programme.
abstract: OBJECTIVE
  Diabetic retinopathy screening aims to detect people at risk of visual loss due to proliferative diabetic retinopathy, but also refers cases of suspected macular oedema (maculopathy). At the introduction of screening, ophthalmology was concerned that referral rates would be unmanageable. We report yield of referable disease by referral reason for the first 5 years of the programme.
  
  
  METHODS
  We extracted screening results from a nationwide clinical diabetes database to calculate annual referral rates to ophthalmic clinics. We used logistic regression to examine associations between clinical measures and referable disease.
  
  
  RESULTS
  182 397 people underwent ≥ 1successful retinal screening between 2006 and 2010. The yield of referable eye disease was highest in the first 2 years of screening (7.0% and 6.0%) before stabilising at ∼4.3%. The majority of referrals are due to maculopathy with 73% of referrals in 2010 based on a finding of maculopathy.
  
  
  CONCLUSIONS
  The commonest cause for referral is for suspected macular oedema (maculopathy). Referral rates for retinopathy have stabilised, as predicted, at relatively low rates. However, ophthalmology workload continues to rise as new treatment options (ie, monthly intraocular injections) have unexpectedly increased the impact on ophthalmology. A review of the screening referral path for maculopathy may be timely.
authors.affiliation: University of Dundee, Dundee, UK.
authors.forename: H C
authors.initials: HC
authors.lastname: Looker
authors.affiliation: University of Dundee, Dundee, UK.
authors.forename: S O
authors.initials: SO
authors.lastname: Nyangoma
authors.affiliation: NHS Lanarkshire, Glasgow, UK.
authors.forename: D T
authors.initials: DT
authors.lastname: Cromie
authors.affiliation: NHS Grampian, Aberdeen, UK.
authors.forename: J A
authors.initials: JA
authors.lastname: Olson
authors.affiliation: Ninewells Hospital & Medical School, Dundee, UK.
authors.forename: G P
authors.initials: GP
authors.lastname: Leese
authors.affiliation: Diabetic Retinopathy Screening Collaborative, NHS Highland, UK.
authors.forename: M W
authors.initials: MW
authors.lastname: Black
authors.affiliation: Forth Valley Royal Hospital, Edinburgh, UK.
authors.forename: J
authors.initials: J
authors.lastname: Doig
authors.affiliation: Diabetic Retinopathy Screening Collaborative, NHS Highland, UK.
authors.forename: N
authors.initials: N
authors.lastname: Lee
authors.affiliation: University of Glasgow, Glasgow, UK.
authors.forename: R S
authors.initials: RS
authors.lastname: Lindsay
authors.affiliation: Western General Hospital, Edinburgh, UK University of Edinburgh, Edinburgh, UK.
authors.forename: J A
authors.initials: JA
authors.lastname: McKnight
authors.affiliation: University of Dundee, Dundee, UK.
authors.forename: A D
authors.initials: AD
authors.lastname: Morris
authors.affiliation: Aberdeen Royal Infirmary, Aberdeen, UK.
authors.forename: D W M
authors.initials: DW
authors.lastname: Pearson
authors.affiliation: Grampian Diabetes Research Unit, NHS Grampian, Aberdeen, UK.
authors.forename: S
authors.initials: S
authors.lastname: Philip
authors.affiliation: University of Edinburgh, Edinburgh, UK.
authors.forename: S H
authors.initials: SH
authors.lastname: Wild
authors.affiliation: University of Dundee, Dundee, UK.
authors.forename: H M
authors.initials: HM
authors.lastname: Colhoun
mesh_terms: D000328:Adult; D000368:Aged; D001766:Blindness / Q000517:prevention & control; D001794:Blood Pressure; D016208:Databases, Factual; D003922:Diabetes Mellitus, Type 1 / Q000150:complications; D003924:Diabetes Mellitus, Type 2 / Q000150:complications; D003930:Diabetic Retinopathy / Q000175:diagnosis* / Q000453:epidemiology; D005260:Female; D006801:Humans; D008269:Macular Edema / Q000175:diagnosis* / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009313:National Health Programs; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D012042:Registries / Q000706:statistics & numerical data; D012307:Risk Factors; D012606:Scotland / Q000453:epidemiology
keywords: Epidemiology; Macula; Retina