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Clinical Sciences
April 11, 2011

Screening for Presence or Absence of Diabetic Retinopathy: A Meta-analysis

Author Affiliations

Author Affiliations: National Trauma Research Institute (Dr Bragge, Prof Gruen, and Ms Chau) and Department of Epidemiology and Preventive Medicine, Monash University, Alfred Hospital (Prof Forbes) and Harold Mitchell Chair of Indigenous Eye Health, Melbourne School of Population Health, The University of Melbourne (Prof Taylor), Melbourne, Victoria, Australia.

Arch Ophthalmol. 2011;129(4):435-444. doi:10.1001/archophthalmol.2010.319

In 2000, 171 million people were estimated to have diabetes, and more than 5 million became blind owing to diabetic retinopathy (DR). This number is expected to double before 2030.1-3 Diabetic retinopathy is progressive change in vascular permeability and a proliferation of fragile, new retinal blood vessels.4-6 The duration of diabetes correlates with both DR and its severity.7,8 Even with optimal glucose control, nearly all diabetic persons will eventually develop DR.

Studies have demonstrated that early diagnosis and laser treatment of DR can prevent severe vision loss.9-11 Because DR has few symptoms until vision loss develops,12 regular DR screening is critical.3,13 Two recognized gold standards for DR screening are ophthalmological examination by a trained health professional (eg, ophthalmologist) using pupillary dilation (mydriasis) and stereoscopic 7-field fundus photography by a trained photographer with image interpretation by an experienced grader.4 Both methods require the specialist equipment and expertise of hospitals and specialist clinics.

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