Nonmydriatic fundus photography in screening for treatable diabetic retinopathy
Nonmydriatic fundus photography in screening for treatable diabetic retinopathy
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DOI：
10.1016/1056-8727(92)90060-x
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发表时间：
1992-01-01
影响因子：
3
通讯作者：
Marks, Jennifer B.
中科院分区：
文献类型：
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作者：
Marks, Jennifer B.
糖尿病视网膜病变是胰岛素依赖型（I型）和非胰岛素依赖型（II型）糖尿病的并发症。美国糖尿病协会和其他人建议筛查视网膜病变，对于I型糖尿病患者，在症状发作后5年开始，对于II型糖尿病患者，在诊断时开始。理想情况下，糖尿病患者由眼科医生在推荐的时间间隔进行评估。但实际上，由于成本和可用性的原因，这通常并不令人担忧。有证据表明，许多糖尿病患者被转介太晚进行干预，可能部分原因是筛查和检测不严，这通常是内科医生和其他初级保健医生的责任。数据支持需要一种廉价、广泛可用、易于使用、有效的筛查工具来检测可治疗的糖尿病视网膜病变。为此，一些研究已经评估了非散瞳眼底照相术，并将其与更成熟的检测糖尿病视网膜疾病的方法进行了比较。需要考虑的真实的问题是，非散瞳眼底摄影是否有助于比普通医生使用检眼镜更好地检测早期可治疗的视网膜病变。一些研究支持其在这方面的作用，并在本次审查中进行了讨论。然而，问题仍然存在，需要进一步研究以评估其潜在作用。
Diabetic retinopathy is a complication of both insulin-dependent (type I) and non-insulin-dependent (type II) diabetes. The American Diabetes Association and others recommend screening for retinopathy, beginning 5 years after onset of symptoms for patients with type I diabetes and at the time of diagnosis for patients with type II diabetes. Ideally, diabetic patients are evaluated at recommended intervals by an ophthalmologist. Realistically, however, this is often not feasable, for reasons both of cost and availability. There is evidence that many diabetic patients are being referred too late for intervention, perhaps in part due to lax screening and detection, often the responsibility of internists and other primary care physicians. Data supports the need for a cheap, widely available, easy-to-use, effective screening tool for detecting treatable diabetic retinopathy. To this end, several studies have evaluated nonmydriatic fundus photography, and compared it with more-established methods of detecting diabetic retinal disease. The real question to be considered is whether nonmydriatic fundus photography will help to detect early treatable retinopathy better than the average physician using ophthalmoscopy. Several studies support its usefulness in this regard, and are discussed in this review. Questions remain, however, and further study is warranted in evaluating its potential role.