Detection of diabetic retinopathy by optometrists.
Detection of diabetic retinopathy by optometrists.
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验光师检测糖尿病视网膜病变。
DOI：
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发表时间：
1987
期刊：
影响因子：
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通讯作者：
W. Louv
中科院分区：
文献类型：
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作者：
R. Kleinstein;J. Roseman;W. Herman;J. Holcombe;W. Louv
验光师检查了25只患有不同严重程度糖尿病视网膜病变的眼睛。未向使用直接或间接检眼镜对散瞳眼进行眼底检查的验光师提供病史或临床信息。彩色立体眼底照片独立分级，并作为标准。验光师对77%的眼睛是否存在视网膜病变做出了正确的诊断（95%置信区间（CI）：73%，82%）。他们在57%的眼睛中对糖尿病视网膜病变的类型和程度做出了正确的诊断（95% CI：39%，75%）。这一诊断率超过了医生检查者的诊断率（39%），与其他唯一类似研究中的普通眼科医生的诊断率（52%）相同。仅使用眼底镜检查诊断糖尿病患者眼中糖尿病视网膜病变的灵敏度为74%（95%CI：67%，81%），而诊断无视网膜病变的特异性为84%（95%CI：73%，96%）。100%的验光师会将患眼转介为增殖前视网膜病变。53%的人会将眼睛归类为增殖性视网膜病变，没有高风险特征，79%的人会将眼睛归类为黄斑水肿。
Optometrists examined 25 eyes with varying severity of diabetic retinopathy. No history or clinical information was provided to the optometrists who performed fundus examinations on dilated eyes using direct or indirect ophthalmoscopes. Color stereoscopic fundus photographs were independently graded and used as the standard. Optometrists made a correct diagnosis of whether retinopathy was present in 77% of the eyes (95% confidence interval (CI): 73%, 82%). They made a correct diagnosis of the type and degree of diabetic retinopathy in 57% of the eyes (95% CI: 39%, 75%). This diagnosis rate exceeded the rate reported for physician examiners (39%) and equaled that of general ophthalmologists (52%) in the only other similar study. Sensitivity for diagnosis of diabetic retinopathy in eyes of diabetic patients using only ophthalmoscopy was 74% (95% CI: 67%, 81%), while specificity for diagnosis of the absence of retinopathy was 84% (95% CI: 73%, 96%). 100% of these optometrists would have referred the eye with preproliferative retinopathy. 53% would have referred the eye classified as proliferative retinopathy without high risk characteristics, and 79% would have referred the eye with macular edema.