Identification and Characterization of Patients With Rapid Progression of Diabetic Retinopathy in the Danish National Screening Program.

Screening for diabetic retinopathy (DR) is needed for identification and treatment of patients with sight-threatening stages prior to irreversible visual loss. For avoidance of unnecessary screening, prolonged screening intervals have been proposed and implemented in Denmark and other countries (1). A potential argument against extended screening intervals is the risk of rapid progression of DR, which has been described anecdotally. Kohner coined the term “florid DR” as rapidly developed advanced stages of proliferative DR (PDR) and reported unfavorable clinical outcomes in 34 patients identified during an 8-year span (2). While individualized screening with prolonged screening intervals might serve the vast majority of patients, it would be important not to risk irreversible visual loss in the minority at risk for rapid progression. Hence, we aimed to quantify the risk of rapid progression of DR and evaluate associated risk factors in a national screening program of DR. In Denmark, screening for DR is nationally implemented and offered for free for all patients with diabetes. According to national guidelines, screening is predominantly performed by fundus photography and level of DR is given by the International Clinical Retinopathy Disease Severity Scale as levels 0 (no …