Gloucestershire Diabetic Retinopathy Research Group, Cheltenham General Hospital, Cheltenham, UK; English NHS Diabetic Eye Screening Programme, Gloucester, UK.
Diabet Med. 2014 Apr;31(4):439-42. doi: 10.1111/dme.12313. Epub 2013 Oct 17.
To assess whether there is a relationship between delay in retinopathy screening after diagnosis of type 2 diabetes and level of retinopathy detected.
Patients were referred from 88 primary care practices to an English National Health Service diabetic eye screening programme. Data for screened patients were extracted from the primary care databases using semi-automated data collection algorithms supplemented by validation processes. The programme uses two-field mydriatic digital photographs graded by a quality assured team.
Data were available for 8183 screened patients with diabetes newly diagnosed in 2005, 2006 or 2007. Only 163 with type 1 diabetes were identified and were insufficient for analysis. Data were available for 8020 with newly diagnosed type 2 diabetes. Of these, 3569 were screened within 6 months, 2361 between 6 and 11 months, 1058 between 12 and 17 months, 366 between 18 and 23 months, 428 between 24 and 35 months, and 238 at 3 years or more after diagnosis. There were 5416 (67.5%) graded with no retinopathy, 1629 (20.3%) with background retinopathy in one eye, 753 (9.4%) with background retinopathy in both eyes and 222 (2.8%) had referable diabetic retinopathy. There was a significant trend (P = 0.0004) relating time from diagnosis to screening detecting worsening retinopathy. Of those screened within 6 months of diagnosis, 2.3% had referable retinopathy and, 3 years or more after diagnosis, 4.2% had referable retinopathy.
The rate of detection of referable diabetic retinopathy is elevated in those who were not screened promptly after diagnosis of type 2 diabetes.
评估 2 型糖尿病诊断后视网膜病变筛查延迟与检出的视网膜病变程度之间是否存在关系。
患者从 88 个基层医疗实践机构被转诊到英国国民健康服务糖尿病眼病筛查项目。使用半自动数据采集算法从基层医疗数据库中提取筛查患者的数据，并通过验证过程进行补充。该项目使用双视野散瞳数码照片，并由经过质量保证的团队进行分级。
2005 年、2006 年或 2007 年新诊断为 2 型糖尿病的 8183 名筛查患者有数据可供分析。仅发现 163 名 1 型糖尿病患者，数量不足无法进行分析。新诊断为 2 型糖尿病的 8020 名患者中有数据可供分析。其中，3569 名患者在 6 个月内接受了筛查，2361 名患者在 6 至 11 个月内接受了筛查，1058 名患者在 12 至 17 个月内接受了筛查，366 名患者在 18 至 23 个月内接受了筛查，428 名患者在 24 至 35 个月内接受了筛查，238 名患者在诊断后 3 年或以上接受了筛查。5416 名（67.5%）患者分级为无视网膜病变，1629 名（20.3%）患者一只眼有背景性视网膜病变，753 名（9.4%）患者双眼有背景性视网膜病变，222 名（2.8%）患者有可转诊的糖尿病性视网膜病变。从诊断到筛查的时间与检出的视网膜病变恶化程度呈显著趋势（P = 0.0004）。在诊断后 6 个月内接受筛查的患者中，有 2.3%患者有可转诊的视网膜病变，而在诊断 3 年或以上的患者中，有 4.2%患者有可转诊的视网膜病变。
在 2 型糖尿病诊断后未能及时进行视网膜病变筛查的患者中，可转诊的糖尿病性视网膜病变检出率较高。
