Screening for Diabetes-Related Eye Disease

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Effectiveness of interventions to promote screening for diabetic retinopathy, by X. Zhang and colleagues. Am J Prev Med 33:318-335, 2007.

What is the problem and what is known about it so far?

Retinal disease is a serious complication of diabetes, known as diabetic retinopathy. This is one the most common form of blindness among adults in the U.S. Early detection and treatment are important to reduce blindness due to diabetic retinopathy.

There are a variety of ways people can be screened for diabetic retinopathy. But little is known about whether some methods are more effective than others.

Why did the researchers do this particular study?

The researchers wanted to assess ways that people are screened for diabetic retinopathy, and to try to figure out what works well and what doesn’t.

Who was studied?

The project compared 48 studies that were reported in medical journals, with a total of 162,157 people.

How was the study done?

The researchers made a list of types of screening strategies, such as public education programs, letters or phone calls from hospitals or medical providers, annual diabetes assessment programs, electronic management systems, community programs, and other approaches.

What did the researchers find?

A number of strategies are effective for screening people for diabetic retinopathy. In general, programs were effective if they increased awareness of diabetic retinopathy among doctors and patients, improved access to health care, used a computer-based registration or reminder system, collaborated with local organizations that do retinal screening, and developed a community-based health care system.

What are the limitations of the study?

Because there are so many strategies, it is difficult to compare their effectiveness. Also, there could be differences in local health care systems that affect the screening and treatment of diabetic retinopathy that were not assessed by the studies in the meta-analysis.

What are the implications of the study?

Screening programs can work if they increase the awareness of diabetic retinopathy and improve the underlying health care system. More research is needed to explore ways of reaching diverse and disadvantaged populations.