In the September 1994 issue of the Archives, Klein et al1 conclude that their study confirms current guidelines for ophthalmologic care of patients with diabetes. After a thorough review of their data, we think that their results contradict the guideline that all people with diabetes need annual screening examinations. The annual examination standard does not reflect the findings of Klein et al1-4 that the risk of treatable retinopathy depends on the status of the retina at a baseline examination. We conclude that the data of Klein et al1 support a screening interval of 2 years or more, depending on the sensitivity of the method, for patients with retinopathy levels 21 or less at their last examination.
Tables 7 and 8 in the article by Klein et al1 show that among 708 patients with no retinopathy at baseline, in only 1.2% to 2.5% did proliferative diabetic retinopathy
Batchelder T, Barricks M. The Wisconsin Epidemiologic Study of Diabetic Retinopathy. Arch Ophthalmol. 1995;113(6):702-703. doi:10.1001/archopht.1995.01100060024015