Role of Diabetologist in Evaluating Diabetic Retinopathy
Role of Diabetologist in Evaluating Diabetic Retinopathy
复制标题
糖尿病专家在评估糖尿病视网膜病变中的作用
DOI：
10.2337/diacare.14.1.26
复制
发表时间：
1991
期刊：
影响因子：
16.2
通讯作者：
T. Topping
中科院分区：
文献类型：
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作者：
D. Nathan;Howard A. Fogel;J. Godine;P. Lou;D. D’Amico;C. D. Regan;T. Topping
objective To evaluate the ability of diabetologists to screen diabetic patients for diabetic retinopathy. Research Design and Methods Comparison of eye examination performed by diabetologists with direct ophthalmoscopy through an undilated pupil and by ophthalmologists through a dilated pupil with seven-field stereoscopic fundus photography (gold standard). The study consisted of 67 insulin-dependent and non-insulin-dependent diabetic outpatients attending a diabetes clinic. Results On the basis of fundus photography, patients were classified as having no or insignificant (30%), minimal (31%), moderate (24%), or severe (15%) retinopathy. The diabetologists and ophthalmologists performed similarly in their ability to classify severity of diabetic retinopathy accurately. When no or insignificant retinopathy (isolated microaneurysms only) was detected by examination, clinically significant retinopathy detected by fundus photography was highly unlikely (< 5%). On the other hand, if more than isolated microaneurysms were seen on examination, all examiners missed more severe lesions detected by fundus photography. Patients with corrected visual acuity worse than 20/30 had a high likelihood (100%) of moderate or severe retinopathy. Conclusions Motivated well-trained diabetologists can screen for diabetic retinopathy. The absence of detectable lesions by direct ophthalmoscopy indicates that automatic referral to an ophthalmologist is not necessary. However, if any level of retinopathy is detected or corrected acuity is worse than 20/30, referral to an ophthalmologist is required. In this setting, fundus photography is advised because it is the most sensitive means of detecting clinically significant retinopathy. If other nonophthalmologists can be trained to achieve similar results, current recommendations for ophthalmologic referral that require annual ophthalmologic examinations for most diabetic patients may need to be reconsidered.
影响因子：
--
作者：
KLEIN, R;KLEIN, BEK;DEMETS, DL
通讯作者：
DEMETS, DL
检眼镜检查和眼底照相在确定糖尿病视网膜病变严重程度方面的比较。
影响因子：
13.7
作者：
Moss,SE;Klein,R;Kessler,SD;Richie,KA
通讯作者：
Richie,KA
使用检眼镜、免散瞳相机和标准眼底相机检测到的糖尿病视网膜病变。
影响因子：
13.7
作者：
Klein,R;Klein,BE;Neider,MW;Hubbard,LD;Meuer,SM;Brothers,RJ
通讯作者：
Brothers,RJ