The Royal Australian and New Zealand College of Ophthalmologists (RANZCO) New Zealand branch has issued a position statement with strategies to address the country’s “fractured” diabetic retinopathy (DR) screening programme.
Estimates show diabetes is present in 7%, and prediabetes in 26%, of the New Zealand population. Of those with diabetes, it is estimated that 20-25% have DR, the leading cause of blindness in Kiwis under 50 years old. “Patients are also losing vision because early treatment was not available to them as they were not identified as needing it. This particularly affects Māori and Pasifika people,” said RANZCO NZ. The recommendations included are:
- A national DR screening programme supported by a telehealth IT system integrated into the existing health IT ecosystem and led by ophthalmologists
- A national training programme and standards for DR screening, noting that retinal cameras are now cheaper and more portable, do not require pupil dilation and could be installed in pharmacies, GP rooms, marae or local health or community centres
- Placing OCT machines at selected DR screening sites to allow many patients to be monitored within the community rather than having to travel to the eye clinic. Optometrists, who often have OCT machines, are less likely to generate unnecessary referrals
- Involvement of GPs, social workers, Māori and Pasifika, plus upskilling of allied staff via RANZCO training
- Use of artificial intelligence for DR image grading
“Because of the fractured nature of the current programme, records and information about patients are not easily accessible or transferable. Many of those within the existing public health services’ screening programmes are mobile and move between centres. The existing, fragmented structure means that people are at grave risk of missing out on screening. A national programme would facilitate the seamless transfer of patients between centres,” said RANZCO NZ.
For RANZCO’s full position statement, see https://tinyurl.com/4bvc8eer
