Askew Deborah, Schluter Philip J, Spurling Geoffrey, Maher Clare M, Cranstoun Peter, Kennedy Craig, Jackson Claire
Discipline of General Practice, The University of Queensland.
Aust Fam Physician. 2009 Aug;38(8):650-6.
Early detection and treatment of diabetic retinopathy (DR) can prevent nearly all associated severe vision loss. We investigated the feasibility of DR screening using nonmydriatic cameras in two Australian primary care clinics.
Two general practitioners from Queensland photographed the retinas of patients with type 2 diabetes seen in their clinics during the 9 month study period. The patients were then photographed and assessed by two independent ophthalmologists. The ophthalmologists' assessments provided the reference standard. General practitioners' accuracy in determining photograph interpretability and DR diagnostic sensitivity and specificity were measured. The attitudes of GPs about the DR screening were also assessed.
One hundred and fourteen patient participants provided 219 photographs. Two ophthalmologists read 158 photographs and deemed 61% (97/158) interpretable, but GPs tended to accept more photographs for interpretation. General practitioners' diagnostic sensitivity and specificity was 87% and 95% respectively. Participating GPs were very positive about expanding their clinical role into DR screening.
General practice based DR screening was feasible and acceptable in the clinics studied, but photograph quality was an issue.
糖尿病视网膜病变（DR）的早期检测和治疗几乎可以预防所有相关的严重视力丧失。我们在两家澳大利亚初级保健诊所研究了使用免散瞳相机进行DR筛查的可行性。
在为期9个月的研究期间，来自昆士兰的两名全科医生对其诊所中2型糖尿病患者的视网膜进行拍照。然后由两名独立的眼科医生对患者进行拍照和评估。眼科医生的评估作为参考标准。测量全科医生在确定照片可解释性以及DR诊断敏感性和特异性方面的准确性。还评估了全科医生对DR筛查的态度。
114名患者参与者提供了219张照片。两名眼科医生阅读了158张照片，认为61%（97/158）的照片可解释，但全科医生倾向于接受更多照片进行解读。全科医生的诊断敏感性和特异性分别为87%和95%。参与的全科医生对将其临床角色扩展到DR筛查非常积极。
在所研究的诊所中，基于全科医疗的DR筛查是可行且可接受的，但照片质量是一个问题。
