Olafsdóttir E, Stefánsson E
University of Iceland, University Hospital Landspitali, 101 Reykjavik, Iceland.
Br J Ophthalmol. 2007 Dec;91(12):1599-601. doi: 10.1136/bjo.2007.123810. Epub 2007 Jul 12.
To evaluate the safety of every-other-year eye screening for patients with diabetes without retinopathy.
Since 1994, patients with diabetes without retinopathy in Iceland have received eye screening every other year. 296 patients with diabetes who had no diabetic retinopathy in 1994/95 were followed with biennial eye examinations until they had developed retinopathy. The 10-year experience of this approach is reviewed.
Out of the 296 diabetic individuals, 172 did not develop diabetic retinopathy during the 10-year observation period. 96 patients developed mild non-proliferative retinopathy, six developed clinically significant diabetic macular oedema, 23 developed preproliferative retinopathy, and four developed proliferative diabetic retinopathy during the 10-year observation period. All the patients who developed macular oedema or proliferative retinopathy had already been diagnosed as having mild nonproliferative retinopathy and entered an annual screening protocol before the sight-threatening retinopathy developed. No patient had any undue delay in treatment.
Every other year screening for diabetic eye disease seems to be safe and effective in diabetics without retinopathy. Such an approach will reduce the number of screening visits more than 25%. This reduces health costs and strain on resources considerably and relieves the patients with diabetes from unnecessary clinic visits and examinations.
评估对无视网膜病变的糖尿病患者每隔一年进行眼部筛查的安全性。
自1994年以来,冰岛无视网膜病变的糖尿病患者每隔一年接受一次眼部筛查。对1994/1995年无糖尿病视网膜病变的296例糖尿病患者进行了每两年一次的眼部检查随访,直至他们出现视网膜病变。回顾了这种方法的10年经验。
在296例糖尿病患者中,172例在10年观察期内未发生糖尿病视网膜病变。96例患者出现轻度非增殖性视网膜病变,6例出现具有临床意义的糖尿病黄斑水肿,23例出现增殖前期视网膜病变,4例在10年观察期内出现增殖性糖尿病视网膜病变。所有出现黄斑水肿或增殖性视网膜病变的患者在视力威胁性视网膜病变发生之前已被诊断为轻度非增殖性视网膜病变,并进入了年度筛查方案。没有患者在治疗上有任何不当延误。
对无视网膜病变的糖尿病患者每隔一年进行一次糖尿病眼病筛查似乎是安全有效的。这种方法将减少超过25%的筛查就诊次数。这将大大降低医疗成本和资源压力,并使糖尿病患者免于不必要的门诊就诊和检查。