Skip to main content
SpringerLink
Log in

Screening of the Retina in Diabetes Patients by Morphological Means

  • Chapter
  • First Online:
Teleophthalmology in Preventive Medicine

Abstract

Diabetic retinopathy (DR) is one of the major microvascular complications of diabetes. It is the most common cause of vision loss and blindness in the working-age people. This chapter firstly introduces DR pathological features and DR screening standards. The chapter then focuses on colour fundus image-based DR detection and DR screening using identification of morphological features. The chapter is also discussing the current progress of DR screening programmes based on colour fundus image grading and cost-effectiveness of DR screening programmes.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
eBook
USD 16.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 79.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Similar content being viewed by others

References

  1. Juutilainen A, Lehto S, Rönnemaa T, Pyörälä K, Laakso M. Retinopathy predicts cardiovascular mortality in type 2 diabetic men and women. Diabetes Care. 2007;30:292–9.

    Article  PubMed  Google Scholar 

  2. Wong TY, Rosamond W, Chang PP, et al. Retinopathy and risk of congestive heart failure. JAMA. 2005;293:63–9.

    Article  CAS  PubMed  Google Scholar 

  3. Edwards MS, Wilson DB, Craven TE, et al. Associations between retinal microvascular abnormalities and declining renal function in the elderly population: the Cardiovascular Health Study. Am J Kidney Dis. 2005;46:214–24.

    Article  PubMed  Google Scholar 

  4. http://www.who.int/mediacentre/factsheets/fs312/en/index.html. Online available: Sept 2012.

  5. http://new.paho.org/hq/index.php?option=com_content&view=article&id=244&Itemid=1&lang=en&limitstart=1. Online available: Jan 2013.

  6. Huang ES, Basu A, O’Grady M, Capretta JC. Projecting the future diabetes population size and related costs for the U.S. Diabetes Care. 2009;32(12):2225–9.

    Article  PubMed Central  PubMed  Google Scholar 

  7. Silva PS, Cavallerano JD, Aiello LM, Aiello L. Telemedicine and diabetic retinopathy: moving beyond retinal screening. Arch Ophthalmol. 2011;129(2):236–42.

    Article  PubMed  Google Scholar 

  8. Early treatment of diabetic retinopathy study research group: grading diabetic retinopathy for stereoscopic colour fundus photographs an extension of the modified airlie house classification (report 10). Ophthalmology. 1991;98:786–806.

    Google Scholar 

  9. Wilkinson CP, Ferris FL, Klein RE, Lee PP, Agardh CD, Davis M, Dills D, Kampik A, Pararajasegaram R, Verdaguer JT. Proposed international clinical diabetic retinopathy and diabetic macular oedema disease severity scales. Ophthalmology. 2003;10(9):1677–82.

    Google Scholar 

  10. American Academy of Ophthalmology Retina Panel, Preferred Practice Pattern – Diabetic Retinopathy. Am Acad Ophthalmol. 2008. http://one.aao.org/CE/PracticeGuidelines/PPP.aspx. Online available: Aug 2013.

  11. Retinopathy Working Party. A protocol for screening for diabetic retinopathy in Europe. Diabet Med. 1991;8:263–7.

    Google Scholar 

  12. UK National Screening Committee, Essential Elements in Developing a Diabetic Retinopathy Screening Programme. http://diabeticeye.screening.nhs.uk/. Online available: Aug 2013.

  13. Owens DR, Dolben J, Young S, Ryder REJ, Jones IR, Vora J, et al. Screening for diabetic retinopathy (symposium). Diabet Med. 1991;8:S4–10.

    Article  PubMed  Google Scholar 

  14. Hulme SA, Tin-U A, Hardy KJ, Joyce PW. Evaluation of a district-wide screening programme for diabetic retinopathy utilizing trained optometrists using slit-lamp and Volk lenses. Diabetes UK, Diabet Med. 2002;19:741–5.

    Article  CAS  Google Scholar 

  15. Squirrell DM, Talbot JF. Screening for diabetic retinopathy. J R Soc Med. 2003;96(6):273–6.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  16. Massin P, Erginay A, Ben Mehidi A, et al. Evaluation of a new nonmydriatic digital camera for detection of diabetic retinopathy. Diabet Med. 2003;20:635–41.

    Article  CAS  PubMed  Google Scholar 

  17. Lin DY, Blumenkranz MS, Brothers RJ, Grosvenor DM. The Digital Diabetic Screening Group, The sensitivity and specificity of single-field nonmydriatic monochromatic digital fundus photography with remote image interpretation for diabetic retinopathy screening: a comparison with ophthalmoscopy and standardized mydriatic color photography. Am J Ophthalmol. 2002;134(2):204–13.

    Article  PubMed  Google Scholar 

  18. Rudnisky CJ, Hinz BJ, Tennant MT, et al. High resolution stereoscopic digital fundus photography versus contact lens biomicroscopy for the detection of clinically significant macular oedema. Ophthalmology. 2002;109:267–74.

    Article  PubMed  Google Scholar 

  19. Massin P, Aubert JP, Erginay A, Bourovitch JC, BenMehidi A, Audran G, Bernit B, Jamet M, Collet C, Laloi-Michelin M, Guillausseau PJ, Gaudric A, Marre M. Screening for diabetic retinopathy: the first telemedical approach in a primary care setting in France. Diabetes Metab. 2004;30(5):451–7.

    Article  CAS  PubMed  Google Scholar 

  20. Creuzot-Garcher C, Malvitte L, Sicard AC, Guillaubey A, Charles A, Beiss JN, Bron A. How to improve screening for diabetic retinopathy: the Burgundy experience. Diabetes Metab. 2010;36(2):114–9.

    Article  CAS  PubMed  Google Scholar 

  21. Peto T, Tadros C. Screening for diabetic retinopathy and diabetic macular oedema in the United Kingdom. Curr Diab Rep. 2012;12:338–45.

    Google Scholar 

  22. Massin P, Angioi-Duprez K, Bacin F, et al. Recommandations de l’ALFEDIAM pour le dépistage et la surveillance de la rétinopathie diabétique. Diabetes Metab. 1996;22:203–9.

    CAS  PubMed  Google Scholar 

  23. Newman M. Fiscal impact of AB 175: analysis of the cost effectiveness of store and forward teleophthalmology: Blue Sky Consulting Group, 2009. http://www.chcf.org. Online available: Aug 2013.

  24. Andonegui J, Zurutuza A, Arcelus MPD, Serrano L, Eguzkiza A, Auzmendi M, Gaminde I, Aliseda D. Diabetic retinopathy screening with non-mydriatic retinography by general practitioners: 2-year results. Prim Care Diabetes. 2012;6:201–5.

    Article  PubMed  Google Scholar 

  25. Georgievski Z, Koklanis K, Fenton A, KouKouras I. Victorian orthoptists’ performance in the photo evaluation of diabetic retinopathy. Clin Experiment Opthalmol. 2007;35:733–8.

    Article  Google Scholar 

  26. Lee P, Durham NC. Telemedicine, opportunities and challenges for the remote care of diabetic retinopathy. Arch Ophthalmol. 1999;117:1639–40.

    Article  CAS  PubMed  Google Scholar 

  27. Massin P, Aubert JP, Eschwege E, Erginay A, Bourovitch JC, BenMehidi A, Nougarède M, Bouéee S, Fagnani F, Tcherny MS, Jamet M, Bouhassira M, Marre M. Evaluation of a screening program for diabetic retinopathy in a primary care setting Dodia (Dépistage ophtalmologique du diabète) study. Diabetes Metab. 2005;31(2):153–62.

    Article  CAS  PubMed  Google Scholar 

  28. Rubino A, Rousculp MD, Davis K, Wang J, Girach A. Diagnosed diabetic retinopathy in France, Italy, Spain, and the United Kingdom. Prim Care Diabetes. 2007;1(2):75–80.

    Article  CAS  PubMed  Google Scholar 

  29. Kilstad HN, Sjølie AK, Gøransson L, Hapnes R, Henschien HJ, Alsbirk KE, Fossen K, Bertelsen G, Holstad G, Bergrem H. Prevalence of diabetic retinopathy in Norway: report from a screening study. Acta Ophthalmol. 2012;90:609–12.

    Article  PubMed  Google Scholar 

  30. Hansen AB, Andersen MVN. Screening for diabetic retinopathy in Denmark: the current status. Acta Ophthalmol Scand. 2004;82(6):673–8.

    Article  PubMed  Google Scholar 

  31. Massin P, Angioi-Duprez K, Bacin F, et al. Recommendations of the ALFEDIAM (French Association for the Study of Diabetes and Metabolic Diseases) for the screening and surveillance of diabetic retinopathy. J Fr Ophtalmol. 1997;20:302–10.

    CAS  PubMed  Google Scholar 

  32. Schulze-Döbold C, Erginay A, Robert N, Chabouis A, Massin P. Ophdiat(®): five-year experience of a telemedical screening programme for diabetic retinopathy in Paris and the surrounding area. Diabetes Metab. 2012;38(5):450.

    Article  PubMed  Google Scholar 

  33. Deb N, Thuret G, Estour B, Massin P, Gain P. Screening for diabetic retinopathy in France. Diabetes Metab. 2004;30:140–5.

    Article  CAS  PubMed  Google Scholar 

  34. Massin P, Chabouis A, Erginay A, Viens-Bitker C, Lecleire-Collet A, Meas T, et al. OPHDIAT: a telemedical network screening system for diabetic retinopathy in the Île-de-France. Diabetes Metab. 2008;34:227–34.

    Article  CAS  PubMed  Google Scholar 

  35. Hazin R, Colyer M, Lum F, Barazi MK. Revisiting Diabetes 2000: challenges in establishing nationwide diabetic retinopathy prevention programs. Am J Ophthalmol. 2011;152:723–9.

    Article  PubMed  Google Scholar 

  36. Hazin R, Barazi MK, Summerfield M. Challenges to establishing nationwide diabetic retinopathy screening programs. Curr Opin Ophthalmol. 2011;22(3):174–9.

    Article  PubMed  Google Scholar 

  37. Wilson RR, Silowash R, Anthony L, Cecil RA, Eller A. Telemedicine process used to implement an effective and functional screening program for diabetic retinopathy. J Diabetes Sci Technol. 2008;2(5):785–91.

    Article  PubMed Central  PubMed  Google Scholar 

  38. Cuadros J, Bresnick G. EyePACS: an adaptable telemedicine system for diabetic retinopathy screening. J Diabetes Sci Technol. 2009;3(3):509–16.

    Article  PubMed Central  PubMed  Google Scholar 

  39. Quade R, Aulakh V. Chapter 15. Economics of screening for diabetic retinopathy using telemedicine in California’s safety net. Digital teleretinal screening. Springer Heidelberg New York Dordrecht, London. 2012. ISBN 9783642258091.

    Google Scholar 

  40. Misra A, Bachmann MO, Greenwood RH, Jenkins C, Shaw A, Barakat O, Flatman M, Jones CD. Trends in yield and effects of screening intervals during 17 years of a large UK community-based diabetic retinopathy screening programme. Diabet Med. 2009;26:1040–7.

    Article  CAS  PubMed  Google Scholar 

  41. Christie B. Scotland to start screening programme for diabetic retinopathy. BMJ. 2002;324(7342):871.

    Article  PubMed Central  PubMed  Google Scholar 

  42. Welsh Assembly Government. National Service Framework for Diabetes in Wales – Delivery strategy. 2003. http://www.wales.nhs.uk/documents/DiabetesNSF_eng.pdf. Online available: Aug 2013.

  43. Yeo ST, Edwards RT, Luzio SD, Charles JM, Thomas RL, Peters JM, Owens DR. Diabetic retinopathy screening: perspectives of people with diabetes, screening intervals and costs of attending screening. Diabet Med. 2012;29:878–85.

    Article  CAS  PubMed  Google Scholar 

  44. Scanlon PH. The English national screening programme for sight-threatening diabetic retinopathy. J Med Screen. 2008;15(1):1–4.

    Article  CAS  PubMed  Google Scholar 

  45. McCarty CA, Lloyd-Smith CW, Lee SE, Livingston PM, Stanislavsky YL, Taylor HR. Use of eye care services by people with diabetes: the Melbourne Visual Impairment Project. Br J Ophthalmol. 1998;82(4):410–4.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  46. Harper AC, Livingstone PM, Wood C, et al. Screening for diabetic retinopathy using a non-mydriatic retinal camera in rural Victoria. Aust N Z J Ophthalmol. 1998;26:117–21.

    Article  CAS  PubMed  Google Scholar 

  47. Alawi EA, Ahmed AA. Screening for diabetic retinopathy: the first telemedicine approach in a primary care setting in Bahrain. Middle East Afr J Ophthalmol. 2012;19(3):295–8.

    Article  PubMed Central  PubMed  Google Scholar 

  48. Mak DB, Plant AJ, McAllister I. Screening for diabetic retinopathy in remote Australia: a program description and evaluation of a developed model. Aust J Rural Health. 2003;11:224–30.

    PubMed  Google Scholar 

  49. Arora S, Kolb S, Goyder E, McKibbin MM. Trends in the incidence of visual impairment resulting from diabetic retinopathy in the Leeds metropolitan area. Diabet Med. 2012;29(7):e112–6.

    Article  CAS  PubMed  Google Scholar 

  50. Patra S, Gomm EMW, Macipe M, Bailey C. Interobserver agreement between primary graders and an expert grader in the Bristol and Weston diabetic retinopathy screening programme: a quality assurance audit. Diabet Med. 2009;26:820–3.

    Article  CAS  PubMed  Google Scholar 

  51. Manjunatha RS, Manjunatha NP, Baskar V, Headon MP, Singh BM, Viswanath AK. Quality assurance in the diabetic retinopathy screening programme: evaluating the benefit of universal regrading of the normal primary grade. Diabet Med. 2012;29(2):287–8.

    Article  CAS  PubMed  Google Scholar 

  52. Vijan S, Hofer TP, Hayward RA. Cost utility of screening intervals for diabetic retinopathy in patients with type 2 diabetes mellitus. JAMA. 2000;283:889–96.

    Article  CAS  PubMed  Google Scholar 

  53. Davies R, Roderick P, Canning C, Brailsford S. The evaluation of screening policies for diabetic retinopathy using simulation. Diabet Med. 2002;19:762–70.

    Article  CAS  PubMed  Google Scholar 

  54. Tung T, Shih H, Chen S, Chou P, Liu C, Liu J. Economic evaluation of screening for diabetic retinopathy among Chinese type 2 diabetics: a community-based study in Kinmen, Taiwan. J Epidemiol. 2008;18(5):225–33.

    Article  PubMed  Google Scholar 

  55. Polak BC, Crijns H, Casparie AF, Niessen LW. Cost-effectiveness of glycaemic control and ophthalmological care in diabetic retinopathy. Health Policy. 2003;64:89–97.

    Article  CAS  PubMed  Google Scholar 

  56. Jones S, Edwards RT. Diabetic retinopathy screening: a systematic review of the economic evidence. Diabet Med. 2009;27:249–56.

    Article  Google Scholar 

  57. Whited JD, Datta SK, Aiello LM, et al. A modeled economic analysis of a digital tele-ophthalmology system as used by three federal health care agencies for detecting proliferative diabetic retinopathy. Telemed J E Health. 2005;11(6):641–51.

    Article  PubMed  Google Scholar 

  58. Rachapelle S, Legood RA, Alavi Y, Lindfield R, Sharma T, Kuper H, Polack S. The cost–utility of telemedicine to screen for diabetic retinopathy in India. Ophthalmology. 2013;120(3):566–73.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. The Australian e-Health Research Centre, DPAS, CSIRO, 65 Brockway Rd, Floreat, WA, 6014, Australia

    Di Xiao PhD & Yogesan Kanagasingam PhD

Authors
  1. Di Xiao PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Yogesan Kanagasingam PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Yogesan Kanagasingam PhD .

Editor information

Editors and Affiliations

  1. Department of Ophthalmology, University Erlangen-Nürnberg, Erlangen, Germany

    Georg Michelson

Rights and permissions

Reprints and permissions

Copyright information

© 2015 Springer-Verlag Berlin Heidelberg

About this chapter

Cite this chapter

Xiao, D., Kanagasingam, Y. (2015). Screening of the Retina in Diabetes Patients by Morphological Means. In: Michelson, G. (eds) Teleophthalmology in Preventive Medicine. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-44975-2_2

Download citation

  • DOI: https://doi.org/10.1007/978-3-662-44975-2_2

  • Published:

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-662-44974-5

  • Online ISBN: 978-3-662-44975-2

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation