Screening for Diabetic Retinopathy in Denmark

Diabetic Retinopathy (DR) is the most common complication in diabetes and a leading cause of blindness in the working-aged population. Consistent, well-timed screening is needed to identify patients with sight-threatening proliferative DR or diabetic macular edema in order to initiate timely treatment prior to irreversible visual loss. Since 2010, national DR-screening has been implemented in Denmark and is offered for free for all patients with diabetes. Approximately 100,000 patients are annually screened by practicing ophthalmologists or hospital-based screening facilities. Screening is performed according to national guidelines, which includes specific recommendations regarding classification of DR, examination techniques, individualized screening intervals, and automated screening. Most importantly, life-long screening should be performed in all patients with diabetes as given by individualized, risk-based intervals including at least 2-field fundus photography and optical coherence tomography (for patients with suspected clinically significant macular edema). Results are mandatorily reported in the Danish Registry of Diabetic Retinopathy, which includes data of 593,769 screening episodes of 207,220 patients. At some hospital-based screening clinics, telemedicine has been implemented as part of a same-day screening initiative, which includes combined evaluation of systemic parameters and all microvascular complications.