Trends in certifications of overall vision impairment and that due to diabetic retinopathy/maculopathy in England and Wales, 2009/2010 to 2019/2020: a retrospective database analysis

Thomas, R.L., John, Rebecca, Bunce, Catey, Xing, Wen, Zekite, Antra, Flanagan, Declan, Williams, Gwyn Samuel, Reynolds, Rhianon and Owens, David 2025. Trends in certifications of overall vision impairment and that due to diabetic retinopathy/maculopathy in England and Wales, 2009/2010 to 2019/2020: a retrospective database analysis. BMJ Open 15 (1) , e090597. 10.1136/bmjopen-2024-090597

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Abstract

ObjectivesThis study aims to report the trends in the certification of both sight impairment (SI) and severe sight impairment (SSI) in England and Wales during the period of 2010 to 2020, prior to the COVID-19 pandemic. The focus is on diabetic retinopathy/maculopathy as the key causative factor.DesignRetrospective database analysis.SettingEngland and Wales.ParticipantsIndividuals certified as SI or SSI.Outcome measuresTrends in certification of vision impairment in England and Wales due to any cause, with specific attention to diabetic retinopathy.MethodsCertifications of vision impairment made by ophthalmologists in England and Wales were recorded and copies were sent to Moorfields Eye Hospital for epidemiological analysis. All certificates completed in England and Wales over an 11-year period, from April 2009 to March 2020, were queried and analysed on an annual basis. This analysis included all causes, and where both the main cause was diabetic eye disease or where diabetic eye disease was a contributory cause among multiple pathologies. Poisson regression was employed to analyse changes in trends over time for certifications of vision impairment.ResultsIn England, from 2010 to 2020, there was a small but significant reduction (pConclusionsThe findings underscore the importance of understanding regional variations in certification rates, particularly in the context of diabetic retinopathy. Despite fluctuations in Wales, the overall reduction in certifications due to diabetic retinopathy in both regions suggests a critical need for ongoing public health initiatives aimed at preventing vision impairment linked to diabetes. However, to provide a true reflection of the burden of vision impairment and its various causes, ensuring that all eligible people are certified is a prerequisite. Continuing attempts to limit the incidence of vision impairment due to diabetic retinopathy remain a priority.

Item Type:	Article
Date Type:	Published Online
Status:	Published
Schools:	Optometry and Vision Sciences
Additional Information:	License information from Publisher: LICENSE 1: Title: cc by-nc, Type: cc by-nc
Publisher:	BMJ Publishing Group
Date of First Compliant Deposit:	3 February 2025
Date of Acceptance:	3 January 2025
Last Modified:	03 Feb 2025 10:32
URI:	https://orca.cardiff.ac.uk/id/eprint/175838

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