Jacobsen Nina, Kjer Birgit E, Goldschmidt Ernst, Andersen Ole Ortved, Thorsteinsson Birger
Hillerød Sygehus, øjenafdelingen, Medicinsk Afdeling F.
Ugeskr Laeger. 2003 Jul 21;165(30):2953-6.
Screening for diabetic retinopathy in a Danish county--are we following the recommendations? Incidence and risk factors of development and progression of diabetic retinopathy and prevalence of blindness among type 1 diabetics consulting the hospital of Hillerød are being described.
A total of 223 type 1 diabetics (debut < 30 years of age, insulin treated from first year of diagnosis) identified in a cross-sectional study in 1993 and followed until 2000 when data from last examination in the diabetes out-patient clinic and the ophthalmology clinic are registered.
Ophthalmologists have screened nearly 97% of the patients as stated in the recommendations of the department. Only 2% were blind and only one patient went blind during the study period. The incidence of development of retinopathy was (54/119) 45%, (14/104) 13% had improved, (77/194) 40% had a progression of retinopathy, and (30/194) 15% had progressed to proliferative retinopathy. Risk factors found in the study match previously described risk factors.
Audits encourage the implementation of screening programmes and hence reduce sight threatening diabetic retinopathy. The results of the study emphasize the importance of close co-operation between diabetes out-patient clinics and ophthalmologists and the necessity of regular screening. More audits are needed to bring screening for diabetic eye disease into focus and decrease the number of weak-sighted and blind diabetics.
丹麦一个郡的糖尿病视网膜病变筛查——我们是否遵循了相关建议？本文描述了在希勒勒医院就诊的1型糖尿病患者中糖尿病视网膜病变的发生、发展和进展的发病率、风险因素以及失明患病率。
在1993年的一项横断面研究中确定了总共223例1型糖尿病患者（发病年龄<30岁，自诊断第一年起接受胰岛素治疗），并随访至2000年，记录糖尿病门诊和眼科门诊最后一次检查的数据。
眼科医生按照该部门的建议对近97%的患者进行了筛查。在研究期间，只有2%的患者失明，仅有1例患者失明。视网膜病变的发生率为（54/119）45%，（14/104）13%的病情有所改善，（77/194）40%的视网膜病变有所进展，（30/194）15%进展为增殖性视网膜病变。研究中发现的风险因素与先前描述的风险因素相符。
审核有助于筛查项目的实施，从而减少威胁视力的糖尿病视网膜病变。该研究结果强调了糖尿病门诊与眼科医生密切合作的重要性以及定期筛查的必要性。需要进行更多审核，以使糖尿病眼病筛查受到关注，并减少视力低下和失明的糖尿病患者数量。
