![]() Manual grading of fundus photographs for large numbers of people with diabetes by trained graders incur substantial costs to the healthcare systems. ![]() ![]() DR screening programmes employ different types of validated fundus cameras for retinal imaging and trained image graders/trained optometrists/ophthalmologists for interpretation of referable DR. Various imaging modalities, especially, colour fundus photography (CFP) has established important role in DR screening for early detection, assessment of progression and monitoring of treatment response. Lifelong evaluation for DR by repetitive retinal screening of people with diabetes is a valuable and essential strategy. A universal screening programme for DR aims early identification of people with DR who are at high risk and ensure timely referral to the ophthalmologist/retina specialist to initiate treatment before the development of advance damage. As the clinical course of DR has a long asymptomatic phase, individuals with diabetes may not visit the ophthalmologist regularly for DR screening unless they are aware of visual loss due to STDR. Traditionally, ophthalmologists have screened for DR by performing direct ophthalmoscopy, slit lamp bio-microscopy and indirect ophthalmoscopy for entire retinal examination after pupil dilatation (mydriasis). It is one of the most common causes of avoidable blindness with diabetic macular oedema (DMO) and proliferative diabetic retinopathy (PDR) being the two major sight-threatening forms of DR (STDR). Īs DR is an asymptomatic condition that can progress to irreversible vision loss without timely treatment, it is a candidate condition that meets all the criteria for a universal screening programme. As previous global estimates have shown that one-third of the people with diabetes have some form of DR, this would translate to ~193 million people with some stage of DR by the year 2030. ![]() The rapid increase in prevalence of diabetes is expected to be higher in the low-to-middle income countries (LMIC). It is estimated that about 463 million people have diabetes worldwide, and if the same trend continues, this number is expected to increase to 578 million by 2030 and to an alarming 700 million people with diabetes by the year 2045. Retinal imaging plays a significant role in the screening and management of diabetic retinopathy (DR), the most common microvascular ocular complication of diabetes. We review the different types of fundus cameras currently used in DR screening and management around the world. Fundus cameras with integrated artificial intelligence (AI)-based automated algorithms can also provide instant DR diagnosis and reduce the burden of healthcare systems. Advances in digital imaging such as ultra-wide field imaging and multi-modal imaging have opened new avenues for assessing DR. Good-quality retinal imaging and accurate diagnosis are essential to reduce inappropriate referrals. ![]() Recent increase in numbers of telemedicine programmes based on imaging with digital fundus cameras and remote interpretation has facilitated larger population coverage of DR screening and timely referral of those with sight-threatening DR to ophthalmologists. The images captured with these low-cost devices can be immediately sent to trained ophthalmologists for grading of DR. Smartphone-based fundus cameras and handheld fundus cameras that are cost-effective, portable and easy to handle in remote places are gaining popularity in recent years. DR screening programmes use validated mydriatic or non-mydriatic fundus cameras for retinal imaging and trained image graders identify referable DR. CFP has established roles in DR screening, detection, progression and monitoring of treatment response. Colour fundus photography (CFP) is helpful for documentation of the retinopathy as well as for counselling the patient. Lifelong repetitive screening for DR is essential for early detection and timely management to prevent visual impairment due to the silent sight-threatening disorder. The global burden of diabetes has resulted in an increase in the prevalence of diabetic retinopathy (DR), a microvascular complication of diabetes. ![]()
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