{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T12:30:10Z","timestamp":1753878610224,"version":"3.41.2"},"reference-count":21,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2025,2,3]],"date-time":"2025-02-03T00:00:00Z","timestamp":1738540800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabet Med"],"published-print":{"date-parts":[[2025,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aims<\/jats:title><jats:p>The aim was to determine the effect of the COVID\u201019 pandemic on diabetic retinopathy and referral rates in the English National Health Service (NHS) Diabetic Eye Screening Programme (DESP).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Non\u2010patient identifiable data are submitted centrally from the 57 regional centres in the NHS DESP on a quarterly basis and analysed using STATA, comparing 01\/04\/2019\u201331\/03\/2020 and 01\/04\/2021\u201331\/03\/2022. Patient characteristics were analysed from National Diabetes Audit (NDA) data.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There were 2,274,635 grades from the 57 centres in 2019\u20132020 and 2,199,623 grades in 2021\u20132022. The proportion of eyes with referable DR increased from 3.1% in 2019\u20132020 to 3.2% in the 2021\u20132022 NHS year (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01) with a small increase in the level of non\u2010referable DR from 24.6% to 24.8% (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01). The median proportion of ungradable eyes in 2019\u20132020 was 2.6% (IQR: 2.3% to 3.3%) increasing to 3.1% (IQR: 2.5% to 3.7%) in 2021\u20132022. NDA data demonstrated that the proportions with type 1 diabetes receiving eye screening were higher in the latter year (8.3% vs. 7.3%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The COVID\u201019 pandemic was associated with small increases in referable retinopathy rates from 3.1% to 3.2%, non\u2010referable DR from 24\u00b76% to 24.8% and an increase in the ungradable image rate from 2.6% to 3.1%, the latter increase possibly being caused by untreated cataract during the pandemic. Risk stratification of invitations in the recovery period was believed to have contributed to keeping the referable rates low and supports a similar approach in extension of the screening interval for low\u2010risk groups.<\/jats:p><\/jats:sec>","DOI":"10.1111\/dme.15518","type":"journal-article","created":{"date-parts":[[2025,2,4]],"date-time":"2025-02-04T06:13:27Z","timestamp":1738649607000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Effect of the <scp>COVID<\/scp>\u201019 pandemic on diabetic retinopathy and referral levels in the English National Health Service Diabetic Eye Screening Programme"],"prefix":"10.1111","volume":"42","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8513-710X","authenticated-orcid":false,"given":"P. H.","family":"Scanlon","sequence":"first","affiliation":[{"name":"Gloucestershire Retinal Research Group (GRRG) Gloucestershire Hospitals NHS Foundation Trust  Cheltenham UK"},{"name":"Nuffield Department of Clinical Neuroscience University of Oxford  Oxford UK"},{"name":"University of Gloucestershire  Cheltenham UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4548-3902","authenticated-orcid":false,"given":"C. F. E.","family":"Norridge","sequence":"additional","affiliation":[{"name":"Gloucestershire Retinal Research Group (GRRG) Gloucestershire Hospitals NHS Foundation Trust  Cheltenham UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"D.","family":"Prentis","sequence":"additional","affiliation":[{"name":"NHS England  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7432-5786","authenticated-orcid":false,"given":"N.","family":"Holman","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Bio\u2010Statistics Imperial College  London UK"},{"name":"School of Population Health Royal College of Surgeons of Ireland  Dublin Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P.","family":"Rankin","sequence":"additional","affiliation":[{"name":"NHS England  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9756-4061","authenticated-orcid":false,"given":"J.","family":"Valabhji","sequence":"additional","affiliation":[{"name":"NHS England  London UK"},{"name":"Division of Metabolism, Digestion and Reproduction, Imperial College London Chelsea and Westminster Hospital Campus  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,2,3]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00592-017-0974-1"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2013-004015"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00592-021-01687-w"},{"key":"e_1_2_8_5_1","unstructured":"PHE.Diabetic eye screening: surveillance pathways. 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