National screening programme for diabetic retinopathy

doi:10.1136/bmj.323.7319.998

BMJ 2001;323:998 ( 27 October )

Letters

National screening programme for diabetic retinopathy

Screening by optometrists is better than screening by fundus photography

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Screening by optometrists is better than screening by fundus photography

The first 150 words of the full text of this article appear below.

EDITOR $---$ We have concerns about the National Screening Committee's recommendations for a risk reduction programme for diabeticretinopathy, in which digital photography is the screening methodof choice.¹ The gold standard for fundus examination is slitlamp biomicroscopy performed by an experienced ophthalmologist;this is the standard on which treatment decisions are made. Thesame technique used by other trained professionals in a screeningenvironment duplicates the goldstandard.

Slit lamp biomicroscopy has advantages over fundus photography. It offers a stereoscopic view, thereby detecting diffuse macularoedema that is missed by photography. The entire post-equatorialretina can be examined with this technique, whereas even seven-fieldphotography misses about 17% of the retina.²

The technical failure rate of photography is high and has been reported to be 14.4%, compared with only 2.2% for ophthalmoscopyin the same group.³ In our district the technical failure rateof slit lamp biomicroscopy is . . . [Full text of this article]

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This article has been cited by other articles:

van Leiden, H. A., Moll, A. C., Dekker, J. M., Abramoff, M. D., Polak, B. C.P. (2003). Photography or Ophthalmoscopy for Detection of Diabetic Retinopathy?. Diabetes Care 26: 1318-1319 [Full text]
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Screening by retinal photographs offers holistic package of diabetic care: Clive B Prince
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