What is RetCAT™?
RetCAT™ is a computerized adaptive testing (CAT) system that measures the impact of diabetic retinopathy (DR) and diabetic macular edema (DME), and associated vision loss and DR/DME treatments on multiple domains of quality of life.
Domains and items in RetCAT™
The 10 patient-identified quality of life domains in RetCAT™ include 279 items that are specific
to diabetic retinopathy, macular edema, and associated vision impairment.
Visual Symptoms
Items
Items
Experience of unwanted visual disturbances
Activity limitation
Items
Items
Difficulty performing daily living activities
Mobility
Items
Items
Difficulty getting out and about independently
Emotional
Items
Items
Emotional reactions and psychological effects
Concerns
Items
Items
Concerns or worries about current and future impact
Social
Items
Items
Problems keeping up with usual social activities, roles and responsibilities
Convenience
Items
Items
Bother associated with restrictions on daily life and the burden of treatment
Economic
Items
Items
Work-related difficulties and financial impacts
Driving
Items
Items
Difficulty driving in different situations and having restrictions on driving
Lighting
Items
Items
Difficulty doing activities in challenging lighting conditions
Publications
Domain & item development
Qualitative interviews with patients and experts in the field.
Content refinement
Expert panel discussions and cognitive interviews with patients.
Pilot testing
Psychometric testing of item banks using data from over 500 patients with DR/DME.
Evaluation
CAT platform development and evaluation of RetCAT using data from 180 patients with DR/DME
Utilisation
RetCAT™ is currently being used in clinical care in patients with DME to measure the impact of intravitreal injections on quality of life at the Singapore National Eye Centre.
Multi-Centre Implementation of RetCAT™ in Singapore (2024–2025)
RetCAT™ was deployed across retinal clinics at SNEC, TTSH, and NUH using hybrid and in-clinic models, achieving high patient uptake and demonstrating the feasibility of routine quality-of-life collection in diabetic eye disease care.
RetCAT™ is being used at the San Giuseppe Hospital in Milan, Italy to determine the patient-centered gains in QoL following intravitreal injections in patients with DME.
Association Between RetCAT™ and Microperimetry Parameters in Diabetic Macular Edema
In a clinical study at San Giuseppe Hospital in Milan, RetCAT™ scores were shown to correlate strongly with retinal sensitivity and fixation stability, highlighting the importance of linking functional retinal measures with patient-reported quality of life outcomes.
