Advances in screening and diabetic eye disease detection

Ocular Surgery News U.S. Edition, published cover story – “Advances in imaging technologies improve screening, detection of diabetic eye disease” on August 25, 2014.

An extract from the story reads…

For years, the main reason for ophthalmic screening in patients with diabetes has been to detect the presence of diabetic retinopathy or diabetic macular edema — both of which may lead to blindness if untreated — relying on either a dilated fundus examination or color photography.
One expert estimated that a dilated fundus examination performed by an ophthalmologist detects diabetic retinopathy in more than 90% of cases. Even so, subtle diabetic macular edema may not be picked up without an optical coherence tomography examination, according to David M. Brown, MD, FACS, of Retina Consultants of Houston. “In 30% of cases of diabetic macular edema, you will miss it without either a good exam or an OCT,” Brown said.
Even as a growing number of clinicians are enthusiastically adopting photographic screening programs for diabetic retinopathy, these programs “are not considered a replacement for a comprehensive eye evaluation by an ophthalmologist experienced in managing diabetic retinopathy,” according to the American Academy of Ophthalmology Preferred Practice Pattern.
On the other hand, in a review of diabetic retinopathy management guidelines that appeared in Expert Review of Ophthalmology, the authors noted, “While the slit lamp has advantages of availability and affordability compared with photography, the disadvantages of its routine use in a low-resourced setting included availability of trained ophthalmic staff and need for pupil dilation.”