The impact of cessation of screening for diabetic eye disease on people with diabetes during the COVID-19 pandemic

Aims:

To evaluate the impact of stopping screening for diabetic eye disease i.e. diabetic retinopathy (DR), due to the COVID-19 pandemic across Wales. Reintroduction of screening will provide essential information on the effect of the delay on pre-existing diabetic retinopathy and the sight of people with diabetes and their quality of life.

The knowledge gained from this research will help to determine for each individual a safe interval between screening episodes to avoid the occurrence and progression of sight-threatening retinopathy and blindness with the introduction of timely medical and/or surgical intervention. This information will inform the relevant allocation of resources if and when faced with future pandemics.

Background:

Currently in the UK, diabetic retinopathy screening (DRS) is performed usually once a year with a small number of people requiring to be reviewed more often because of a higher risk of developing sight-threatening DR. COVID-19 has seen all non-urgent services stopped in March 2020 with screening for DR planned to re-start in Wales during September 2020.

What you hope to discover:

The effect stopping screening had on people with diabetes and healthcare professionals as well as their opinions on the future of the service. Whether or not there was any impact of COVID-19 or the cessation of screening on the progression of diabetic retinopathy and whether there was any changes in the rates of development of sight-threatening DR and numbers seeking emergency eye care.

This information would then be used to inform policy should future lockdowns or pandemics arise.

Patient and public involvement:

People including BAME persons and carers of people with diabetes will be very much involved in this study as their experience before, during and after the pandemic will be an important part in judging the appropriateness of the current screening service and for planning its future.

We have an established public reference panel including people with diabetes, parents of children with diabetes and young persons with diabetes. Three members of this panel have been fully involved at each stage in the design and development of this study, reviewing and finalising the proposal. The panel members will also be involved in developing and testing planned questionnaires. Some of the panel members will also be on the different steering groups for the study so that their views are considered throughout. We have tried to ensure that the health, safety and wellbeing of all people with diabetes undergoing screening or attending hospital eye services are fully considered in this application.

Dissemination:

The findings from this study will be reported to our public reference group, and Public Health Wales with manuscripts submitted for publication in peer reviewed journals. Presentations at related national and international conferences will also be undertaken. The public representatives involved in this study will present at meetings of people with diabetes and prepare lay summaries to published on our diabetes research group website.