Screening for Diabetic Retinopathy in the Central Region of Portugal. Added Value of Automated ‘Disease/No Disease' Grading

Abstract

Purpose: To describe the procedures of a nonmydriatic diabetic retinopathy (DR) screening program in the Central Region of Portugal and the added value of the introduction of an automated disease/no disease analysis. Methods: The images from the DR screening program are analyzed in a central reading center using first an automated disease/no disease analysis followed by human grading of the disease cases. The grading scale used is as follows: R0 - no retinopathy, RL - nonproliferative DR, M - maculopathy, RP - proliferative DR and NC - not classifiable. Results: Since the introduction of automated analysis in July 2011, a total of 89,626 eyes (45,148 patients) were screened with the following distribution: R0 - 71.5%, RL - 22.7%, M - 2.2%, RP - 0.1% and NC - 3.5%. The implemented automated system showed the potential for human grading burden reduction of 48.42%. Conclusions: Screening for DR using automated analysis allied to a simplified grading scale identifies DR vision-threatening complications well while decreasing human burden.