Integrating Diabetic Eye Screening into Regional Haemodialysis Units, Northern Ireland

Design: Cohort Study
Purpose: To determine attendance at the Diabetic Eye Screening Programme in Northern Ireland, diabetic retinopathy severity and use of handheld retinal imaging in people with diabetes attending haemodialysis units in Northern Ireland.
Methods: All patients with diabetes attending haemodialysis clinics regionally were offered diabetic eye screening in their respective regional haemodialysis renal clinics. Macula centred and disc centred fundus images were taken using both a conventional non-mydriatic fundus camera and a handheld fundus camera. All images were then graded by trained graders and ophthalmic professionals in the Diabetic Eye Screening Programme.
Results: All eligible 149 people were offered a Diabetic Eye Screening Programme appointment. Of these, 132 attended, 33.8% of whom have not been seen in >3 years and 15% had never attended Diabetic Eye Screening Programme in Northern Ireland despite multiple previous appointment offers. Our results show that approximately 24% had STDR with 12.9% requiring urgent referral to hospital eye services which is much higher than the national average of 0.4%.
Conclusions: Those on haemodialysis are at high risk for sight threatening diabetic retinopathy, implementing Diabetic Eye Screening Programme in Northern Ireland in haemodialysis clinics enables timely diagnosis and referral.