New Zealand already has a variety of local diabetic retinopathy screening services, some of which are very effective. The updated standards for grading, referral and monitoring set out in this guidance document recognise that some established programmes will have to adjust their processes and also that technology is quickly evolving. As a result this guidance aims to promote further convergence of regional services thereby reducing variation and providing a national benchmark.
The guidance outlines the key components of an organised diabetic retinal screening service so that high-quality, equitable screening can be provided for all those at risk of diabetic eye disease. It represents a statement of best practice, based on stakeholder consultation, evidence and is intended to guide the delivery of a nationally consistent programme.
There are strong links with the New Zealand Primary Care Handbook 2012 (updated 2013), the Quality Standards for Diabetes Care 2014 and Living Well with Diabetes 2015. Although the emphasis is on type 2 diabetes, pregnancy, children and adults with type 1 diabetes are also addressed to ensure they have the support of an organised retinal screening programme.
Key recommendations include:
- revising the screening interval and updating the retinal screening pathway
- informing people that dilation is a choice
- central coordination for each regional screening service with monitoring by an optometrist and ophthalmologist oversight
- providing screening and monitoring results within three weeks to the person with diabetes, their GP and referring clinician
- undertaking collection and storage of a core national minimum data set for analysis purposes.