NICE work by Christiana
The first ever NICE guidance for diabetic retinopathy has been published.
Christiana Dinah, an ophthalmologist at Central Middlesex Hospital and Director of Research Innovation, is one of three diabetic retinopathy experts involved in developing the guidance.
Christiana said: “It is timely given the exponential rise in diabetes. The NHS spends more than £10 billion a year on diabetes related care with almost one million people on ophthalmology waiting lists around the UK.
“Cases are now so commonplace that NICE, to its credit, recognised the need for national guidelines. This is nothing new in North-West London where we have been treating a large volume of ethnically diverse patients with diabetic retinopathy for many years.
“Diabetes affects more than five million people in the UK, with Brent, Ealing and Harrow having some of the highest rates in the country.”
The ophthalmologist says the guidance can help standardise treatment across the country and help address inequalities in the care for people with diabetic retinopathy, with reports of people from minoritised backgrounds often waiting longer for treatment.
Diabetic retinopathy, where blood vessels in the film that lines the back of the eye (retina) are damaged, is one of the most common complications of diabetes and the guidance aims to ensure care delivered in the hospital eye service across the country is of uniformly of high quality.
Central Middlesex has been an outlier in the multi-disciplinary management of diabetic retinopathy for many years and punches well above its weight in clinical trials and research including the latest eye injection treatments which slow the diseases’ progress.
Christiana added: “I am particularly proud that the guidance includes acknowledgement of the difference in retina measurements based on gender and ethnicity. This may influence treatment of diabetic macular oedema which is the most common cause of sight loss due to diabetes."
The team at Central Middlesex were the first to alert its patients to the disparity in retinal measurements and its inclusion in the guidelines offer the prospect of earlier access to first line treatment for patients nationally and, potentially, globally given NICE’s reputation.
Christiana added: "The management of diabetes and its complications is holistic and the NICE guidance panel consisted of diabetic retinopathy experts, as well as a GP, nurse, optometrist, pharmacist, patients with lived experience, eye clinic liasion officer and diabetologist.
"It’s been a three-year journey to reach this point and has been personally transformational, tying in research findings with policy development and implementation with a multi-disciplinary group that has a unified vision to deliver the best care for people with diabetic retinopathy everywhere.”