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  • Title: Managing 'suspicious glaucomatous discs' identified during digital-photography-based diabetic retinopathy screening.
    Author: Steele C, Steel D, Bone H, McParland L, Green L, Fraser S.
    Journal: Ophthalmic Physiol Opt; 2006 Jan; 26(1):19-25. PubMed ID: 16390478.
    Abstract:
    PURPOSE: An audit to demonstrate the outcome of patients identified with suspicious glaucomatous discs within a digital-photography-based diabetic retinopathy screening programme. METHODS: Primary care based digital photographic screening was performed utilising mydriasis and two-field digital photography for all patients with diabetes. Patients identified with discs suspicious of glaucomatous optic neuropathy (GON) were initially referred to an accredited community-based optometrist for further assessment. Some patients were then referred to secondary care where appropriate. RESULTS: From 1st April 2002 to 31st March 2003 a total of 3868 patients were screened for diabetic retinopathy. This audit revealed that 55 subjects were identified by retinal screeners as having discs suspicious of glaucoma. A total of 29 were already under glaucoma clinic review. A total of 23/26 remaining were referred for an assessment by an accredited optometrist. Of these 13 were normal, 6 were referred to secondary care and 4 failed to attend. The three remaining were referred directly to secondary care. CONCLUSIONS: All nine referrals to secondary care were deemed appropriate by a glaucoma specialist. This suggests that the system described does not lead to over-referral of suspicious discs - although the issue of how many glaucomatous discs are missed during screening (false negatives) will only be answered in the longer term.
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