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Background/Objectives <p>It remains unclear whether routine annual diabetic eye screening is still warranted for individuals aged 80 and over who show no signs of retinopathy at baseline. This study aimed to determine the incidence of referable diabetic retinopathy (DR) or diabetic maculopathy in individuals aged 80 years and older with no retinopathy at baseline in the South East London NHS Diabetic Eye Screening Programme (DESP), and to estimate the proportion requiring treatment.</p> Subject/Methods <p>Data from the South East London DESP were linked with Hospital Eye Service (HES) records from 2009 to 2025. Individuals aged 80 years during 2009–2014 with no diabetic retinopathy or maculopathy (R0M0) at baseline and at least five years of follow-up were included. Screening and hospital data were analysed to determine referrals, diagnoses and treatments.</p> Results <p>Of 3599 eligible participants, 3258 (90.5%) had no referable diabetic retinopathy or diabetic maculopathy at final screening. In total, 532 (14.8%) were referred to HES, mainly for non-diabetic causes (56.6%). Referrals for sight-threatening diabetic retinopathy accounted for 89 cases (2.5%), and only four individuals (0.11%) required treatment, all for diabetic macular oedema. No cases of proliferative diabetic retinopathy were identified.</p> Conclusions <p>Among people aged 80 years and older without diabetic retinopathy at baseline, the incidence of sight-threatening disease and treatment need were extremely low. Routine DESP recall in this population may offer limited clinical benefit and should be reconsidered within a risk-stratified screening framework.</p>

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Long-term follow-up and outcomes of a Diabetic Eye Screening Programme in patients aged 80 with no diabetic eye disease at baseline: should we be routinely screening this cohort?

  • 期刊论文

  • 发表日期：

    2026年7月3日

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  • Arianna Paris,
  • Laura Webster,
  • Haralabos Eleftheriadis,
  • Samantha Mann

摘要

Background/Objectives

It remains unclear whether routine annual diabetic eye screening is still warranted for individuals aged 80 and over who show no signs of retinopathy at baseline. This study aimed to determine the incidence of referable diabetic retinopathy (DR) or diabetic maculopathy in individuals aged 80 years and older with no retinopathy at baseline in the South East London NHS Diabetic Eye Screening Programme (DESP), and to estimate the proportion requiring treatment.

Subject/Methods

Data from the South East London DESP were linked with Hospital Eye Service (HES) records from 2009 to 2025. Individuals aged 80 years during 2009–2014 with no diabetic retinopathy or maculopathy (R0M0) at baseline and at least five years of follow-up were included. Screening and hospital data were analysed to determine referrals, diagnoses and treatments.

Results

Of 3599 eligible participants, 3258 (90.5%) had no referable diabetic retinopathy or diabetic maculopathy at final screening. In total, 532 (14.8%) were referred to HES, mainly for non-diabetic causes (56.6%). Referrals for sight-threatening diabetic retinopathy accounted for 89 cases (2.5%), and only four individuals (0.11%) required treatment, all for diabetic macular oedema. No cases of proliferative diabetic retinopathy were identified.

Conclusions

Among people aged 80 years and older without diabetic retinopathy at baseline, the incidence of sight-threatening disease and treatment need were extremely low. Routine DESP recall in this population may offer limited clinical benefit and should be reconsidered within a risk-stratified screening framework.