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Item #5
Less
Frequent Eye Exams May Be Indicated for Some Diabetics
Screening
intervals to be lengthened to 2 or 3 years in the 70% of diabetic
people with no retinopathy
Many
people with type 2 diabetes could go longer between screens for
retinopathy, according to a report published in the January 18th
issue of The Lancet.
Results
from the study, which involved more than 7500 patients with type 2
diabetes, suggest that many type 2 diabetics with no signs of
retinopathy on one exam could go up to 3 years before needing
another exam.
The
evidence is sufficiently strong to allow screening intervals to be
lengthened to 2 or 3 years in the 70% of diabetic people with no
retinopathy," said study author Dr. Simon P. Harding, of
Royal Liverpool University Hospital.
However,
others say it is too soon to revise guidelines that call for
routine yearly tests for diabetic retinopathy--which include the
recommendations of the American Diabetes Association.
Worldwide,
there is no consensus on how often people with diabetes should be
screened for retinopathy. In the US, experts recommend screening
be conducted at least annually. The European Retinopathy Working
Party recommends exams at least every 2 years, and at least yearly
after the first signs of retinopathy.
Existing
guidelines are based on expert opinion rather than "direct
evidence," the researchers note.
However,
they add that patients on insulin and those who have had diabetes
for more than 20 years appear to need yearly screening. Over the
study period, these patients had elevated rates of retinopathy,
even when their initial tests showed no signs of the disorder.
Dr.
Harding and his colleagues also advise that diabetics with mild
preproliferative retinopathy be screened every 4 months.
Lancet
2003;361:195-200
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