Is diabetic retinopathy screening worthwhile among people first diagnosed with diabetes at older ages? Cohort study of Norfolk diabetic retinopathy screening programme.

Diabetic retinopathy screening is less effective and less cost effective with increasing age at diagnosis of diabetes, because of the increasing probability of death before participants develop sight-threatening diabetic retinopathy and can benefit from treatment. Upper age limits on entry into screening programmes or risk stratification in older age groups may therefore be justifiable.