Eye and Vision Epidemiology Research Group, Centre for Health Services Research, School of Population Health, University of Western Australia, Australia.
Clin Exp Ophthalmol. 2011 Apr;39(3):230-5. doi: 10.1111/j.1442-9071.2010.02446.x.
To survey the current diabetic retinopathy screening and management practices of Australian optometrists following the release of the 1997 National Health Medical Research Council Diabetic Retinopathy Management Guidelines.
Cross-sectional national survey, primary care setting.
1000 Australian optometrists across different states.
A self-administered questionnaire was sent to 1000 optometrists across all states during 2007/2008.
Use of retinal camera, screening practices/attitudes and behaviour in diabetic retinopathy management.
568 optometrists (57%) responded to the survey. Patients' unpreparedness to drive post dilation (51%) and the fear of angle closure glaucoma (13%) were the two main barriers to optometrists not performing dilated ophthalmoscopy. Those who had strong desire to screen for diabetic retinopathy were more likely to use a retinal camera (p<0.005). Use of a retinal camera was significantly associated with an increased confidence in detecting clinical signs of diabetic retinopathy including macular oedema (P<0.001). Optometrists who read the guidelines at least once were 2.5-times (P<0.001) more likely to have confidence in detecting macular oedema than those who had never read the guidelines. Although they may be confident in diagnosis, and may use retinal cameras for screening, nearly 60% of optometrists would not refer patients with macular oedema to an ophthalmologist.
Despite their self-reported desire for involvement in diabetic retinopathy, the management of macular oedema by Australian optometrists needs improvement. The use of retinal cameras and promotion of the 2008 NHMRC guidelines should be encouraged to improve overall optometric diabetic retinopathy management, particularly with macular oedema.
在 1997 年国家健康医学研究委员会糖尿病视网膜病变管理指南发布后，调查澳大利亚验光师当前的糖尿病视网膜病变筛查和管理实践。
横断面全国性调查，初级保健环境。
来自不同州的 1000 名澳大利亚验光师。
2007/2008 年期间，向所有州的 1000 名验光师发送了一份自我管理问卷。
视网膜相机的使用、糖尿病视网膜病变筛查实践/态度和管理行为。
568 名验光师（57%）对调查做出了回应。患者散瞳后无法准备开车（51%）和害怕闭角型青光眼（13%）是验光师不进行散瞳眼底检查的两个主要障碍。那些强烈希望筛查糖尿病视网膜病变的人更有可能使用视网膜相机（p<0.005）。使用视网膜相机与检测糖尿病视网膜病变临床体征的信心增加显著相关，包括黄斑水肿（P<0.001）。至少阅读过一次指南的验光师比从未阅读过指南的验光师更有可能有信心检测到黄斑水肿（P<0.001）。尽管他们可能对诊断有信心，并且可能使用视网膜相机进行筛查，但近 60%的验光师不会将黄斑水肿患者转介给眼科医生。
尽管澳大利亚验光师自我报告希望参与糖尿病视网膜病变的管理，但他们对黄斑水肿的管理仍需要改进。应鼓励使用视网膜相机和推广 2008 年 NHMRC 指南，以改善整体眼科糖尿病视网膜病变管理，特别是黄斑水肿。
