Background

The diabetes has serious ophthalmological manifestations: it could cause non-proliferative and proliferative retinopathy, cystoid macular oedema and is one of the most frequent causes of blindness in the developed countries. These manifestations can be prevented in case of early diagnosis and certain disorders can be treated effectively.
Early diagnosis can be based on the screening of the patients at risk.
The result of screening is determined by the recognizable lesions of the retina which can be seen during the examination. The image of the lesions is characteristic for the certain disease. Monitoring and analysis of these lesions helps to separate normal and pathological retina.
Programs like the English National Screening Programme for diabetic retinopathy have been planned all over the world after all this was a properly designed program concerning the largest population. (There was not organized similar screening programme in Hungary because of its high costs.) In the present screening programmes experts distinguish the normal and pathological retina images, and send those patients for further examinations and treatment who are detected with manifestations.
The experts, who pre-screen the digital images, often work in clinical screening centres („Reading Center”), where they analyse the digital images coming from several ophthalmological examination locations. The results are sent to the aspirant few days later.
The system developed during the project will do the pre-screening of the patients absolutely automatically (without human intervention), so the experts must analyse only the images qualified positive. As a result the claim of human resources of the screening and its costs will decrease notably. Through the decrease of the costs it is possible to organise screening programmes at such places where they were not financed before.

Epidemiology

We introduce some epidemiology data to support the importance of the project.

Target population: The target population of the system we would like to develop consists of diabetic patients.

Diabetic retinopathy: An estimated 124 million people had diabetes worldwide in 1997; of which 97% had NIDDM (type 2 diabetes). By 2010 the total number of patients with diabetes is projected to reach 221 million. The regions with the greatest potential increases are Asia and Africa, where diabetes rates could rise to 2 or 3 times those experienced in 1997. (Amos, A. F., McCarty, D. J., Zimmet, P., et al (1997)
Approximately 40% of all people with diabetes have diabetic retinopathy. An estimated 5% of persons with diabetes have the sight-threatening form of this disease. Diabetic retinopathy is the leading cause of new causes of legal blindness among adults 20 to 74 years of age. (American Diabetes Association-National diabetes fact sheet, Retrieved July 7, 2004)
It is estimated that as much as $167 million dollars and 71,000-85,000 sight-years could be saved annually in the U.S. alone with improved retinal screening methods.
/M. Larsen, J. Godt, M. Grunkin, “Automated detection of diabetic retinopathy in a fundus photographic screening population,” Invest Ophthal Vis Sci 2003, 44:767-71./
The treatment of diabetic retinopathy (DR) amounts huge costs, but this is only one eighth of the costs of social security payments for vision loss. This latter cost is dwarf by the social loss of the dropout of work and the decline of the quality of life.

English National Screening Programme for Diabetic Retinopathy

The aim of the screening programme: To reduce new blindness due to diabetic retinopathy
Who carried out screening: Any suitably trained, accredited and competent professional (diabetologist, ophthalmologist, optometrist or retinal screener) can grade the digital images, supported by second opinions, if necessary, from ophthalmologists and/or diabetologists.
Structure of the screening network:
-    Fixed location screening services
-    Mobile screening services
-    Optometric Screening Services

In the course of the screening program digital photos are made about the patient’s retina. These photos are analysed by health care professionals. The management of the screening program has allocated a significant amount on the special training of the health care providers, which increased the costs.
English National Screening Programme For the determination of the main functions of the system we are to develop the needs of this screening program were considered. The system developed in this project can be inserted to this program without any alteration of the program, which makes the product more saleable.
nkth © 2011 DRSCREEN Projekt
Konzorciumi tagok: Astrid Research Kft, 3T Research Kft, Debreceni Egyetem Partner: Moorfields Eye Hospital (London)

 A projektet a Kutatási és Technológiai Innovációs Alap terhére kiírt Nemzeti Technológiai Program Élettudományok alprogramja útján a Nemzeti Kutatási és Technológiai Hivatal támogatja.