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Blog: Early Detection is Key!

Diabetic retinopathy is one of the leading causes of blindness in the working age population around the globe. This serious condition typically presents no symptoms during the early stages, which means it is often at an advanced stage when symptoms become noticeable. Early detection and timely treatment of diabetic retinopathy can in 95% of the cases prevent a person living with diabetes from suffering vision loss and eventual blindness.

Early detection and prevention are however only possible if the millions of people living with diabetes around the world are informed about the importance of eye exams and act on this information.

In several countries, systematic eye screening has been adopted, like in the United Kingdom, where it was recently announced that diabetic retinopathy is no longer the primary cause of blindness in the British working age population. Sadly, only a small part of the current global diabetic population of 463 million have their eyes screened on a regular basis. This may be due to non-availability of eye screening opportunities but even where rigid eye screening programmes exist, non-compliance is a serious issue. What would it take to ensure that every person living with diabetes had access to regular eye screening based on their risk profile? Emerging technologies and increased emphasis on personalized approaches will help. Most of the current screening programs employ mydriatic or non-mydriatic color fundus photography and require trained personnel to grade the images to identify referable diabetic retinopathy. In the last few years, new imaging modalities have been introduced that offer significant improvements in diagnostic accuracy, throughput, and affordability. Smartphone-based fundus photography, macular optical coherence tomography, ultrawide-field imaging, and artificial intelligence-based image reading are some of the emerging technologies addressing the limitations of current approaches.

The clinically validated RetinaRisk algorithm is one of these technologies that can have a significant impact on early detection of diabetic retinopathy, streamlining of eye screening programmes and enhanced education about diabetic retinopathy. The RetinaRisk app, which is available free of charge for all smartphones, empowers persons living with diabetes to assess and monitor their individualized risk of developing sight-threatening diabetic retinopathy, based on their risk profile.

The users insert information about their gender, type and duration of diabetes, diagnosis of retinopathy, blood sugar (HbA1c) level and blood pressure, which allows the app to calculate their individualized risk and demonstrating it using a colour based gauge (green for low risk, yellow for medium risk, red for high risk). With the analysis button, the users can also see which are their key risk factors (HbA1c or blood pressure) and how these can be mitigated to lower the risk of vision impairment.

The RetinaRisk app’s easy-to-visualize risk calculation vividly demonstrates how improvement of modifiable risk factors could significantly lower the risk of potentially blinding diabetic eye disease and expensive interventions. Being aware of their own risk allows persons living with diabetes to take steps to prevent the risk materializing, through timely treatment and change in lifestyle. This would be instrumental to preserving the quality of life for the 463 million persons living with diabetes worldwide and save society at large considerable amounts for treatment.

The RetinaRisk app includes detailed guidelines and useful information about diabetes, diabetic retinopathy and improved self-care, which allows the users to better understand their condition and motivates them to become active participants in their own wellness journey. It empowers persons with diabetes to become more involved in their health care decision-making and drives home the importance of regular eye examinations and timely medical treatment.

by Dr. Einar Stefansson, Professor and Chair of the Department of Ophthalmology at the University of Iceland

The RetinaRisk app was designed by an Iceland-based company founded by Dr. Einar Stefansson, Professor and Chair of the Department of Ophthalmology at the University of Iceland, and Dr. Arna Gudmundsdottir, Endocrinologist at the National Hospital Reykjavik who have over 30 years’ experience in screening for persons with diabetic retinopathy and treating diabetes.

The algorithm at the core of the RetinaRisk app is based on extensive international research on risk factors known to affect the progression of diabetic retinopathy. Clinical validation of RetinaRisk in over 20,000 persons with diabetes is robust and the results have been published in several respected medical journals. Emerging technologies, like the RetinaRisk app, can make a sizable dent in the global fight to eliminate preventable blindness due to diabetes and contribute towards integrated, people-centred eye care that strengthens health systems and meets population needs, as called for in the World Vision Report that was recently published by the World Health Organization (WHO).

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