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The UK-Philippines Remote Retinal Evaluation Collaboration in Health: Diabetic Retinopathy REACH-DR

A Newton project led by Professor Tunde Peto from the School of Medicine, Dentistry and Biomedical Sciences

What is the project about?

One of the major complications of diabetes is vision loss due to a disease known as diabetic retinopathy (DR) that includes diabetic maculopathy affecting predominantly the centre part of the back of the eye, the place of high acuity vision. One of the greatest success stories in diabetes eye care is the United Kingdom's National Diabetic Eye Screening Programme (UK-DESP). In 2014, for the first time in 5 decades, DR was no longer the leading cause of legal blindness in the working-age population in England and Wales, likely due to the early detection of DR by screening, along with improved control of blood sugar levels. As seen in the experience in the UK, the success of a telemedicine programme for diabetic eye disease greatly reduces the incidence of visual loss.

The project seeks to establish a DESP in the Philippines within a well characterized but underserved target population.


What were the project outcomes? 

This project will be pursued in three phases:

  • In the initial phase we will develop the necessary infrastructure jointly by the UK and the Philippine teams. The UK and Philippine principal investigators will perform analysis and validation of existing telemedicine technology with independent expert review from the Joslin Diabetes Center.
  • The second phase will involve adapting selected technologies into the Philippine setting, with the first DR screening being performed under the direct guidance and supervision of the UK team.
  • In the last phase there will be a complete technology transfer to the Philippine stakeholders. Long-term quality assurance and control (QA/QC) programmes will be based on UK-DESP but will be carefully adapted to the Philippine environment to ensure standards and key performance indicators will be continually maintained and patients remain safe in the DESP.


ODA - Direct benefit?  

The proposed teleophthalmology programme for DESP will help to identify eyes at high risk for losing sight, and this will have direct benefit for individuals at risk of losing vision secondary to diabetes. An additional benefit will be the promotion of awareness for the need for eye evaluations which will significantly improve the overall level of eye care and reduce the risk of DR related visual loss in person with diabetes. The ultimate aim of this project will be the implementation of a national programme in the Philippines with a country-wide benefit, but this will be carried out based on appropriate information in order to make it sustainable for the Philippines.