title: Evaluating digital diabetic retinopathy screening in people aged 90 years and over.
abstract: OBJECTIVE
  To evaluate the effectiveness of digital diabetic retinopathy screening in patients aged 90 years and over.
  
  
  METHODS
  This is a retrospective analysis of 200 randomly selected patients eligible for diabetic retinopathy screening aged 90 years and over within the Birmingham, Solihull, and Black Country Screening Programme.
  
  
  RESULTS
  One hundred and seventy-nine (90%) patients attended screening at least once.
  
  
  RESULTS
  133 (74%) annual screening after their first screen, of whom 59% had no detectable diabetic retinopathy; 38 (21%) were referred for ophthalmology clinical assessment-36 for nondiabetic retinopathy reasons and two for diabetic maculopathy. Cataract accounted for 50% of all referrals for ophthalmology clinical assessment. Of the 133 patients placed on annual screening, 93 (70%) were screened at least once more. In terms of level of diabetic retinopathy, assessability or other ocular pathologies, 8 improved, 51 remained stable, and 31 deteriorated. Of the latter, 19 patients were referred for ophthalmology clinical assessment; none of these for diabetic retinopathy.
  
  
  CONCLUSIONS
  Screening provides opportunistic identification of important nondiabetic retinopathy eye conditions. However, in view of the low identification rate of sight-threatening diabetic retinopathy in patients aged 90 years and over, and the current mission statement of the NHS Diabetic Eye Screening Programme, systematic annual diabetic retinopathy screening may not be justified in this age group of patients, but rather be performed in optometric practice.
authors.affiliation: Departments of Diabetes and Ophthalmology, Heartlands Hospital, Birmingham, UK.
authors.forename: A
authors.initials: A
authors.lastname: Tye
authors.affiliation: Departments of Diabetes and Ophthalmology, Heartlands Hospital, Birmingham, UK.
authors.forename: H
authors.initials: H
authors.lastname: Wharton
authors.affiliation: Departments of Diabetes and Ophthalmology, Heartlands Hospital, Birmingham, UK.
authors.forename: A
authors.initials: A
authors.lastname: Wright
authors.affiliation: School of Health and Life Sciences, Aston University, Birmingham, UK.|Birmingham and Midland Eye Centre, City Hospital, Birmingham, UK.
authors.forename: Y
authors.initials: Y
authors.lastname: Yang
authors.affiliation: Departments of Diabetes and Ophthalmology, Heartlands Hospital, Birmingham, UK.|School of Health and Life Sciences, Aston University, Birmingham, UK.
authors.forename: J
authors.initials: J
authors.lastname: Gibson
authors.affiliation: Departments of Diabetes and Ophthalmology, Heartlands Hospital, Birmingham, UK.
authors.forename: A
authors.initials: A
authors.lastname: Syed
authors.affiliation: Departments of Diabetes and Ophthalmology, Heartlands Hospital, Birmingham, UK.
authors.forename: A
authors.initials: A
authors.lastname: Mills
authors.affiliation: Departments of Diabetes and Ophthalmology, Heartlands Hospital, Birmingham, UK.|School of Health and Life Sciences, Aston University, Birmingham, UK.
authors.forename: P
authors.initials: P
authors.lastname: Dodson
mesh_terms: D000369:Aged, 80 and over; D016208:Databases, Factual / Q000706:statistics & numerical data*; D003930:Diabetic Retinopathy / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000706:statistics & numerical data*; D012017:Referral and Consultation; D012189:Retrospective Studies; D013222:State Medicine / Q000706:statistics & numerical data; D006113:United Kingdom / Q000453:epidemiology; D014792:Visual Acuity / Q000502:physiology