Retinopathy screening in individuals with type 2 diabetes: who, how, how often, and at what cost-an epidemiologic review

Diabetic retinopathy is at the convergence of several epidemiologic trends. Although the prevalence of diabetic retinopathy within the population of diagnosed diabetics may be decreasing because of aggressive risk factor reduction, any gains achieved are likely to be negated by the large increase in the prevalence of type 2 diabetes in the population owing to obesity. The epidemiology findings suggest that certain persons with well-controlled type 2 diabetes may not warrant yearly examination for diabetic retinopathy; however, given the low percentage of diabetics who are currently screened for retinopathy, it would seem unwise to recommend changes in the timing of examination. Evidence appears to suggest that photoscreening is a viable alternative to a screening examination.