Two-field photography can identify patients with vision-threatening diabetic retinopathy: a screening approach in the primary care setting.
نویسندگان
چکیده
OBJECTIVE To compare the effectiveness of two 45 degrees photographic fields per eye in the screening for diabetic retinopathy with the routine ophthalmologist's examination and to study the effectiveness of visual acuity measurement in the detection of diabetic macular edema. RESEARCH DESIGN AND METHODS Type 1 and 2 diabetic patients without a known history of more than minimal retinopathy (n = 469) had a routine examination by an ophthalmologist, including visual acuity measurement, indirect retinoscopy, and biomicroscopy. At the same time, two-field nonstereoscopic retinal photographs were made of both eyes and assessed in a masked fashion by a retinal specialist. The results were compared. RESULTS The prevalence was 4.3% for vision-threatening retinopathy and 24% for any retinopathy. The sensitivity of two-field photography in identifying diabetic patients with sight-threatening retinopathy was 95% (specificity 99%) and sensitivity for detecting any retinopathy was 83% (specificity 88%). The percentage of referrals to an ophthalmologist was 6.2%. All patients with macular edema detected by biomicroscopy were classified as having vision-threatening retinopathy on the photographs. CONCLUSIONS Two-field retinal photography is a promising alternative to the routine ophthalmologist's examination in the screening for diabetic retinopathy. Visual acuity measurement is not a sensitive tool for the detection of macular edema. Screening for diabetic retinopathy using two-field retinal photography is feasible in a primary care setting and can substantially lower the number of ophthalmic referrals.
منابع مشابه
Tele-ophthalmology screening for proliferative diabetic retinopathy in urban primary care offices: an economic analysis.
BACKGROUND AND OBJECTIVE To determine whether tele-ophthalmology screening for proliferative diabetic retinopathy (PDR) can be cost-saving. PATIENTS AND METHODS Adults with diabetes presenting for routine medical care underwent non-mydriatic fundus photography with remote grading. Direct medical costs were estimated using the Medicare fee schedule in the base case, with Medicaid and commercia...
متن کاملOphthalmic Technology Assessment Single-Field Fundus Photography for Diabetic Retinopathy Screening A Report by the American Academy of Ophthalmology
Objective: To evaluate whether single-field fundus photography can be used as a screening tool to identify diabetic retinopathy for referral for further ophthalmic care. Methods: A MEDLINE search of the peer-reviewed literature was conducted in June 2001 for the years 1968 to 2001 and updated in September 2003, yielding 145 articles. The search was limited to articles published in English. The ...
متن کاملSingle-field fundus photography for diabetic retinopathy screening: a report by the American Academy of Ophthalmology.
OBJECTIVE To evaluate whether single-field fundus photography can be used as a screening tool to identify diabetic retinopathy for referral for further ophthalmic care. METHODS A MEDLINE search of the peer-reviewed literature was conducted in June 2001 for the years 1968 to 2001 and updated in September 2003, yielding 145 articles. The search was limited to articles published in English. The ...
متن کاملDiabetic retinopathy in diabetics referred to a tertiary centre from a nationwide screening programme.
INTRODUCTION The aim of the study was to describe the prevalence and risk factors for diabetic retinopathy in a multi-ethnic diabetic patient cohort referred for retinal evaluation from a nationwide diabetic retinopathy screening programme in Singapore. MATERIALS AND METHODS Seven hundred and forty-two patients, aged 21 to 95, referred for suspected diabetic retinopathy on annual one-field no...
متن کاملRisk Indicators of Diabetic Retinopathy in Patients with type 2 Diabetes Screened by Fundus Photographs: A Study from Rural India
This study aims to evaluate the risk indicators of diabetic retinopathy in patients with type 2 diabetes screened by fundus photographs at a tertiary care diabetes centre in Tenali, AP, INDIA. A cross-sectional study was conducted at the outpatient department of MAMATHA HOSPITAL, TENALI, from October 2015 to March 2016. Patients >30 years of age were recruited randomly. Demographic, anthropomet...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید
ثبت ناماگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید
ورودعنوان ژورنال:
- Diabetes care
دوره 24 12 شماره
صفحات -
تاریخ انتشار 2001