Screening for sight-threatening diabetic retinopathy: An update

Aims: To review the literature on Screening for Diabetic Retinopathy. Materials and Methods: A comprehensive review of the English language literature, published from March 1980 to June 2014 using key words in Zetoc. Results: Several methods were found to achieve adequate sensitivities and specificities for diabetic retinopathy screening. Studies were compared with respect to (a) Classifications used to grade diabetic retinopathy (b) The evidence for population-based screening for diabetic retinopathy (c) Alternatives to digital photography for screening (d) Reference standards used to study the effectiveness of screening methods (e) The evidence for mydriatic versus non-mydriatic digital photography, or a combination of the two (f) The number of photographic fields captured (g) Measurement of distance visual acuity (h)  Cost-effectiveness of screening for diabetic retinopathy (i) Future developments in screening for diabetic retinopathy Conclusion: Based on an assessment of available studies, the most effective DR screening strategy is the use of mydriatic or staged mydriasis with digital retinal photography. Variables between different screening strategies include whether Visual Acuity is measured and the number of fields captured.