Department of Ophthalmology, University Hospital Sant Joan, Reus, Tarragona, Spain.
Diabetes Res Clin Pract. 2010 May;88(2):184-8. doi: 10.1016/j.diabres.2010.02.001. Epub 2010 Mar 1.
To evaluate the inclusion of family physicians in screening for diabetic retinopathy.
We evaluated by non-mydriatic fundus camera 2779 diabetic patients. The family physicians made an initial evaluation of the fundus and pathological images were sent to a reference ophthalmologist. An audit was taken of all the patients at the end of the study. We analysed the concordance in: diabetic retinopathy, diabetic macular edema, and lesions in the macular area.
Diabetic retinopathy was observed in 226 patients (8.1%) and diabetic macular edema in 40 patients (1.4%). Other retinal pathologies were diagnosed in 291 (11.0%). The sensitivity of the study was 95.2% for diabetic retinopathy, 96.0% for macular lesions and 92.9% for diabetic macular edema. The specificity was above 98% in the three studied variables. Cohen's Kappa coefficient was 0.82 for diabetic retinopathy, 0.81 for diabetic macular edema and 0.96 for macular lesions.
The inclusion of family physicians in the screening system seems to be effective in the diagnosis of diabetic retinopathy.
评估家庭医生参与糖尿病视网膜病变筛查的效果。
我们使用免散瞳眼底相机对 2779 名糖尿病患者进行了评估。家庭医生对眼底进行初步评估，并将病理性图像发送给参考眼科医生。在研究结束时对所有患者进行了审核。我们分析了以下方面的一致性：糖尿病视网膜病变、糖尿病性黄斑水肿和黄斑区病变。
226 名患者（8.1%）出现糖尿病视网膜病变，40 名患者（1.4%）出现糖尿病性黄斑水肿。291 名患者（11.0%）被诊断出其他视网膜病变。该研究的敏感性在糖尿病视网膜病变、黄斑病变和糖尿病性黄斑水肿方面分别为 95.2%、96.0%和 92.9%。在三个研究变量中，特异性均高于 98%。柯恩氏kappa 系数在糖尿病视网膜病变、糖尿病性黄斑水肿和黄斑病变方面分别为 0.82、0.81 和 0.96。
将家庭医生纳入筛查系统似乎可以有效地诊断糖尿病视网膜病变。
