An individualized schedule for retinopathy screening based on several factors lowered eye exam frequency without delaying diagnosis in people with type 1 diabetes, according to a recent study.

Using retinal photographs, investigators developed a screening frequency rationale based on the patient's current state of retinopathy and A1C level. They then determined how likely patients would progress to proliferative diabetic retinopathy or clinically significant macular edema based on whether they had no, mild, or moderate retinopathy; or severe nonproliferative retinopathy. Among the results:

• Overall, the probability of progressing was limited to ~5% between retinal screening examinations at 4 years in patients with no retinopathy.
• This probability held at 3 years for patients with mild retinopathy, 6 months for those with moderate retinopathy, and 3 months for those with severe nonproliferative retinopathy.
• Risk of progression was 1% over 5 years in patients with a 6% A1C level, vs 4.3% over 3 years in those with 10% A1C level.
• Over a 20-year period, eye exam frequency was nearly 60% lower using the proposed schedule, vs routine exams.