Lydia Marahrens

Comment on Leese et al. Progression of Diabetes Retinal Status Within Community Screening Programs and Potential Implications for Screening Intervals. Diabetes Care 2015;38:488–494

There is a discussion about the optimum screening interval for the timely detection of diabetic retinopathy (DR) (1). A low rate of progression in patients without any preexisting retinopathy leads to the hypothesis that extending screening intervals can generally reduce total costs. Unfortunately, the British Four Nations Diabetic Retinopathy Screening Study Group’s recent article on the evaluation of DR progression has severe limitations (1). 1. When adhering to just the broad categorization of “referable” and “treatable” disease, the exact stage of DR remains nontransparent (1). This is a major drawback, as the most appropriate treatment might change in the future when new studies’ data emerge or when the prediction of the individualized risk …

Limited Time from the Diabetes Patients' Perspective: Need for Conversation with the Eye Specialist

Purpose: Facing the lack of time, busy retina consultants should be aware of how the patients would prefer that time is spent and whether they wish the specialist to talk more at the expense of other medical activities. Methods: 810 persons with diabetes were asked to divide the time of 10 min between examination, consultation and treatment when envisioning a real-life scenario of diabetic retinopathy (NCT02311504). Results: With the increasing duration of diabetes, patients wanted significantly more time for diagnostics (p = 0.028), while age was found to be associated with less time for treatment (p = 0.009). Female subjects tended to prefer only little more time for talking (p = 0.051) in comparison with males, who slightly favored therapy (p = 0.025). Conclusions: The large majority recognized the need for diagnostics in their allocation of time. If individual patients are confronted with the health care perspective of time constraints, this might improve the understanding of prioritization.