College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK.
Birmingham, Solihull and Black Country Diabetic Eye Screening Programme, Birmingham, UK.
Eye (Lond). 2023 Dec;37(17):3661-3665. doi: 10.1038/s41433-023-02577-x. Epub 2023 May 20.
To assess the incidence of referable diabetic retinopathy (DR) in patients aged 80 and 85 years to determine whether screening interval can be extended safely in this age group.
Patients who were aged 80 and 85 years when they attended digital screening during April 2014-March 2015 were included. Screening results at baseline and over the next four years were analysed.
1880 patients aged 80 and 1105 patients aged 85 were included. Patients referred to hospital eye service (HES) for DR ranged from 0.7% to 1.4% in the 80-year-old cohort over 5 years. In this cohort a total of 76 (4%) were referred to HES for DR, of which 11 (0.6%) received treatment. Over the course of the follow up (FU), 403 (21%) died. In the 85-year-old cohort, referral to HES for DR each year ranged from 0.1% to 1.3%. In this cohort a total of 27 (2.4%) were referred to HES for DR, of which 4 (0.4%) received treatment. Over the course of follow-up 541(49%) died. All treated cases were for maculopathy in both cohorts and there were no cases of proliferative diabetic retinopathy requiring treatment.
This study showed that the risk of progression of retinopathy is quite low in this age group and only a small proportion of patients developed referable retinopathy requiring treatment. This suggests relooking at the need for screening and ideal screening intervals in patients aged 80 years and over with no referable DR as they can be potentially classed as a group with low risk of sight loss.
评估 80 岁和 85 岁患者中可转诊的糖尿病视网膜病变（DR）的发生率，以确定是否可以安全延长该年龄段的筛查间隔。
纳入 2014 年 4 月至 2015 年 3 月期间接受数字筛查时年龄分别为 80 岁和 85 岁的患者。分析基线和接下来 4 年的筛查结果。
共纳入 1880 名 80 岁患者和 1105 名 85 岁患者。在 5 年内，80 岁患者组中转诊至医院眼科服务（HES）的 DR 患者比例为 0.7%至 1.4%。在该队列中，共有 76 名（4%）因 DR 转诊至 HES，其中 11 名（0.6%）接受了治疗。在随访过程中（FU），403 名（21%）死亡。在 85 岁患者组中，每年转诊至 HES 的 DR 患者比例为 0.1%至 1.3%。在该队列中，共有 27 名（2.4%）因 DR 转诊至 HES，其中 4 名（0.4%）接受了治疗。在随访过程中，541 名（49%）死亡。两个队列中所有接受治疗的病例均为黄斑病变，且无需要治疗的增生性糖尿病视网膜病变病例。
本研究表明，该年龄组中视网膜病变进展的风险相当低，只有少数患者出现需要治疗的可转诊视网膜病变。这表明，对于没有可转诊 DR 的 80 岁及以上患者，重新考虑筛查的必要性和理想的筛查间隔可能是合理的，因为他们可以被归类为低视力风险群体。
