OCT, should this link to a DRS Programme?

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Presentation transcript:

OCT, should this link to a DRS Programme? Dr John Olson

Retinal screening Everyone with diabetes invited for annual photographic screening. Photographs graded. Referred to ophthalmologist if there are signs of potentially sight threatening disease.

Scotland June 2009

Scotland June 2009

Methods Anonymised photographs and grading results Screening centres: NHS Fife and NHS Glasgow Date range: 01/01/2007 – 31/01/2008 Images: 85,884 Episodes: 36,063 Patients: 33,535 Fife: 10412 Glasgow: 25657

Outcomes Grade Number % Automated Confidence Int RO 21,503 64.1% 49.6 48.9-50.3 R1 7,964 23.7% 83.9 83.0-84.6 R2 193 0.6% 99.2 97.8-99.7 M1 387 1.2% 100 M2 1,130 3.4% 97.3 96.1-98.1 R3 324 1.0% 98.8-100 R4 180 0.5% 98.1-100 TF 1,827 5.4% 99.8 99.5-99.9

Ophthalmologists don’t like Technical Failures 5.4% (1,827) M2 3.4% (1130)

Retinal photography Photographs taken using a non-mydriatic digital colour fundus camera (opposite). Give no depth indication; cannot detect oedema directly. Oedema inferred by presence of surrogate features, such as exudates and blot haemorrhages. Which of the following are referable? Which have clinically significant macular oedema…

Project website: http://www.abdn.ac.uk/mos/ Improving the value of screening for diabetic macular oedema using surrogate photographic markers. Project website: http://www.abdn.ac.uk/mos/ HTA 06/402/49

Study centres Study centres Aberdeen Birmingham Dundee Edinburgh Glasgow Liverpool Oxford Aberdeen Dundee Glasgow Edinburgh Liverpool Birmingham Oxford © 2008 Google-Imagery © 2008 TerraMetrics

Impact on Ophthalmology

OCT, should this link to a DRS Programme?