A telemedicine program for diabetic retinopathy in a veterans affairs medical center - the Joslin Vision Network eye health care model
A telemedicine program for diabetic retinopathy in a veterans affairs medical center - the Joslin Vision Network eye health care model
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DOI：
10.1016/j.ajo.2004.10.064
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发表时间：
2005-04-01
影响因子：
4.2
通讯作者：
Aiello, LM
中科院分区：
文献类型：
--
作者：
Cavallerano, AA;Cavallerano, JD;Aiello, LM
目的：利用 Joslin Vision Network (JVN) 扩大糖尿病眼部护理的覆盖范围，并描述糖尿病视网膜病变 (DR) 的程度和其他眼部症状。设计：回顾性观察队列研究。方法：Togus VA Medical 门诊对患有糖尿病、空腹血糖受损或糖耐量受损的患者进行 JVN 协议成像。图像被传输到 Joslin 糖尿病中心进行分级和推荐治疗计划。 结果：该研究包括 1,219 名患者（2,437 只眼睛）； 1,536 只眼睛 (63.0%) 没有 (DR)，389 只 (16.0%) 患有轻度非增殖性 DR (NPDR)，105 只 (4.3%) 中度 NPDR，35 只 (1.4%) 严重 NPDR，20 只 (0.8%) 非常严重 NPDR，21 只 (0.9%) 患有增殖性 DR (PDR)。关于糖尿病性黄斑水肿（DME），1,907只眼睛（78.3%）没有DME，34只眼睛（1.4%）患有早期DME，16只眼睛（0.7%）患有临床显着的黄斑水肿（CSME）。在所有患者中，354 名 (29.0%) 的双眼没有 DR 或轻度 NPDR，没有 DME 证据，也没有明显的非糖尿病症状； 679 名 (55.7%) 的两只眼睛都没有 DR，229 名 (18.8%) 的较严重的眼睛有轻度 NPDR。在 908 名患者（74.5%）中，较严重的眼睛没有 DR 或轻度 NPDR，其中 533 名患者（58.7%）至少有一项非糖尿病眼部发现需要转诊。最后，320 只眼睛 (13.1%) 的 DR 和 DME 均无法分级，160 只 (6.6%) 的眼睛单独 DME 无法分级。结论：在非眼科环境中，JVN iden 确定了 DR 和非糖尿病眼部状况的严重程度，从而可以对眼部护理进行适当的分类。 （Am J Ophasemol 2005；139：597-604。(c) 2005 年 Elsevier Inc. 保留所有权利）。
PURPOSE: To extend access to diabetic eye care and characterize the extent of diabetic retinopathy (DR) and other ocular findings using the Joslin Vision Network (JVN).DESIGN: Retrospective observational cohort study.METHODS: Outpatients at the Togus VA Medical enter with diabetes mellitus, impaired fasting glucose, or impaired glucose tolerance underwent JVN protocol imaging. Images were transmitted to the Joslin Diabetes Center for grading and recommended treatment plan.RESULTS: The study included 1,219 patients (2,437 eyes); 1,536 eyes (63.0%) had no (DR), 389 (16.0%) had mild nonproliferative DR (NPDR), 105 (4.3%) moderate NPDR, 35 (1.4%) severe NPDR, 20 (0.8%) very severe NPDR, and 21 (0.9%) had proliferative DR (PDR). Regarding diabetic macular edema (DME), 1,907 eyes (78.3%) had no DME, 34 (1.4%) had early DME, and 16 (0.7%) had clinically significant macular edema (CSME). Of all patients, 354 (29.0%) had either no DR or mild NPDR in both eyes, no evidence of DME, and no significant nondiabetic findings; 679 (55.7%) had no DR in either eye, and 229 (18.8%) had mild NPDR in the more severe eye. Of the 908 patients (74.5%) with either no DR or mild NPDR in the more severe eye, 533 (58.7%) had at least one nondiabetic ocular finding necessitating referral. Finally, 320 eyes (13.1%) were ungradable for both DR and DME and 160 (6.6%) were ungradable for DME alone.CONCLUSION: In a non-ophthalmic setting, JVN iden, tifies the severity of DR and nondiabetic ocular condi, tions, permitting appropriate triage for eye care. (Am J Ophthalmol 2005;139:597-604. (c) 2005 by Elsevier Inc. All rights reserved).