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ORIGINAL RESEARCH article

Front. Med.

Sec. Ophthalmology

Implementation of Diabetic Retinopathy Screening in the Oslo Region, Norway: A Three-Year Pilot Study

  • 1. University of Oslo, Oslo, Norway

  • 2. Oslo universitetssykehus, Oslo, Norway

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Abstract

Purpose To determine the prevalence and progression of diabetic retinopathy (DR) and its risk factors among patients with diabetes in a three-year pilot DR screening program in the Oslo region. Methods The pilot screening program enrolled 90 adult patients with type 1 (T1D) or type 2 diabetes (T2D) from December 2019 to January 2021. Patients were referred by general practitioners and underwent annual DR screening, including fundus photography and optical coherence tomography (OCT) imaging. Baseline and follow-up data included socio-demographic parameters, diabetes history and medication, glycated hemoglobin (HbA1c), visual acuity, blood pressure, and intraocular pressure. DR severity was graded using the International Clinical Disease Severity Scale for DR, and diabetic macular edema (DME) was identified based on OCT findings. Cox regression analyses were conducted to identify factors associated with DR progression. Results At baseline, prevalence of DR was 27.8%, with 6.7% of the patients exhibiting vision-threatening severe DR (VTDR) and/or DME. Over the three-year follow-up, 24.7% of the patients either developed or showed a progression of DR, with 4% developing VTDRsevere NPDR and/or DME. Duration of diabetes and urine albumin-to-creatinine ratio were significantly associated with DR progression (hazard ratio 1.07 (95% confidence interval 1.02-1.12) and 1.03 (95% confidence interval 1.01 – 1.06), respectively). 13.3% of patients were lost to follow-up, primarily due to the COVID-19 pandemic. Conclusions Most patients had stable DR over the three years. Diabetes duration and albuminuria predicted progression, supporting extended screening intervals for low-risk patients with risk-based stratification.

Summary

Keywords

Albuminuria, Diabetic retinopathy screening, disease progression, Population-based pilot study, risk stratification

Received

17 November 2025

Accepted

10 February 2026

Copyright

© 2026 Sauesund, Brunborg, Jørstad, Moe, Erke, Fosmark and Petrovski. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

*Correspondence: Ellen Steffenssen Sauesund

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