New research found that extending annual screening to two years for people at low-risk of diabetic eye disease could lead to critical treatment delays and sight loss.
It also identified that people of Black and South Asian ethnicity were disproportionately affected when compared to people of White ethnicity.
A study was led by St George’s, University of London and Moorfields Eye Hospital with academics at Kingston University and was published in the British Journal of Ophthalmology.
Professor Christopher Owen, epidemiologist at St George’s, said: ‘The incentive of biennial screening is to release capacity in the NHS and lessen the inconvenience for people with diabetes at low risk of sight loss of attending eye screening appointments every year, but there is a need to address the potential to amplify ethnic and age inequalities in healthcare.’
The study tracked the eye health of 82,782 people with diabetes but no diabetic eye disease in either eye on two previous consecutive screens between 2012 and 2021.
Researchers said the study drew on a large and ethnically diverse database with 36% of participants White, 27% South Asian and 16% were Black.
Over eight years, the study identified who developed the condition and the implications of potential delays in referral for treatment because of an eye exam every two years instead of one.
During this period, 1,788 new cases of moderate to severe diabetic eye disease were picked up in people regarded as being at low risk.
Women had higher rates of sight-threatening diabetic eye disease than men, and those with type 1 diabetes had higher rates than people with type 2 diabetes.
Researchers said there was no clear pattern across levels of deprivation, but ‘striking ethnic differences emerged over time.’
Case rates were significantly higher among Black people, who were 121% more likely to develop sight-threatening diabetic eye disease than White people, while South Asian people were 54% more likely to do so.
Researchers said, based on these figures, extending the annual eye check to two years would have delayed diagnosis by 12 months in 56.5% of those with sight-threatening disease and in 44% of those with the most severe and urgent cases.
Progression to sight-threatening diabetic eye disease was also more pronounced in the youngest (under 45) and oldest (65+) than it was for those in their mid-40s to 60s.