COLOUR VISION TESTING

Colour vision testing in diabetic retinopathy: a systematic review and cost-effectiveness analysis

Background

Blindness from diabetic retinopathy is preventable if eye disease is detected and treated appropriately. The aim of this review was to assess the clinical impact and cost-effectiveness of using colour vision testing in the detection and management of diabetic retinopathy. A baseline audit of current UK practice was undertaken to gather information on the current use of colour vision and other testing in the detection and management of diabetic retinopathy. A systematic review of the literature was undertaken to assess the clinical and cost-effectiveness of using colour vision testing in the detection and management of diabetic retinopathy. The review also considered evidence on the preferences of people with diabetes with respect to testing to detect or monitor the progression of diabetic retinopathy.

Findings

There was insufficient evidence to support the use of colour vision testing (CVT) alone, or in combination with retinal photography, as a method for screening for retinopathy in patients with diabetes. Better quality diagnostic accuracy studies directly comparing the incremental value of CVT in addition to retinal photography are needed before drawing conclusions on cost-effectiveness. The most frequently cited preference for future research among National Screening Programme clinical leads and project managers was the use of optical coherence tomography for the detection of clinically significant macular oedema.

Conducted by: M Rodgers1, R Hodges2, J Hawkins2, W Hollingworth2, S Duffy1, M McKibbin3, M Mansfield4, R Harbord2, J Sterne2, P Glasziou5, P Whiting2, M Westwood1

1. Centre for Reviews and Dissemination; 2. Department of Social Medicine, University of Bristol; 3. Department of Ophthalmology, St James's University Hospital, Leeds; 4. Diabetes and Thrombosis Research Group, Division of Medicine, Leeds General Infirmary; 5. Department of Primary Care, University of Oxford

Further details

Project page on NIHR HTA Programme website

Publications

Rodgers M, Hodges R, Hawkins J, Hollingworth W, Duffy S, McKibbin M, Mansfield M, Harbord R, Sterne J, Glasziou P, Whiting P, Westwood M. Colour vision testing for diabetic retinopathy: a systematic review of diagnostic accuracy and economic evaluation. Health Technol Assess. 2009; 13(60): 1-160

Funding

Commissioned by the NIHR HTA Programme