The Diabetic Retinopathy Screening Workflow: Potential for Smartphone Imaging.
The Diabetic Retinopathy Screening Workflow: Potential for Smartphone Imaging.
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DOI：
10.1177/1932296815617969
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发表时间：
2015-11-23
影响因子：
5
通讯作者：
Bastawrous, Andrew
中科院分区：
文献类型：
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作者：
Bolster, Nigel M;Giardini, Mario E;Bastawrous, Andrew
糖尿病的并发症，即糖尿病视网膜病变和糖尿病黄斑病变，是导致工作老年人失明的主要原因。如果通过视网膜成像及早发现患者，可以避免失明。对糖尿病人群进行系统筛查已被证明可大大降低人群中失明的患病率和发病率。许多全国性的筛查项目都以数字眼底摄影为基础。在过去的5年里，已经开发了几种技术和适配器，允许使用智能手机进行数字眼底摄影。我们回顾了基于智能手机的眼底成像的最新进展，并讨论了其整合到国家系统性糖尿病视网膜病变筛查计划中的潜力。一些系统在与参考标准的一致性方面取得了令人振奋的初步结果。然而，如果要建立一个足以影响政策变化的证据基础，就需要在可实施的筛选工作流程中进一步对这种系统的使用进行多点试验。如果发生这种情况，全国糖尿病视网膜病变筛查将首次在低收入和中等收入环境中成为可能，在这些环境中，训练有素的眼科护理人员的成本和可用性目前是实施的关键障碍。由于糖尿病的患病率和发病率在这些环境中急剧增加，对全球失明的影响可能是深远的。
Complications of diabetes mellitus, namely diabetic retinopathy and diabetic maculopathy, are the leading cause of blindness in working aged people. Sufferers can avoid blindness if identified early via retinal imaging. Systematic screening of the diabetic population has been shown to greatly reduce the prevalence and incidence of blindness within the population. Many national screening programs have digital fundus photography as their basis. In the past 5 years several techniques and adapters have been developed that allow digital fundus photography to be performed using smartphones. We review recent progress in smartphone-based fundus imaging and discuss its potential for integration into national systematic diabetic retinopathy screening programs. Some systems have produced promising initial results with respect to their agreement with reference standards. However further multisite trialling of such systems' use within implementable screening workflows is required if an evidence base strong enough to affect policy change is to be established. If this were to occur national diabetic retinopathy screening would, for the first time, become possible in low- and middle-income settings where cost and availability of trained eye care personnel are currently key barriers to implementation. As diabetes prevalence and incidence is increasing sharply in these settings, the impact on global blindness could be profound.