Kalm H, Egertsen R, Blohmé G
Department of Ophthalmology, University of Goteborg, Sweden.
Acta Ophthalmol (Copenh). 1989 Oct;67(5):546-53. doi: 10.1111/j.1755-3768.1989.tb04106.x.
The spectrum of diabetic retinopathy, the need for fundus screening and the evaluation of two presumptive screening methods, was investigated in a population based study among patients with type II diabetes. Retinal evaluation was performed in 86.9% of the known diabetic population. Background diabetic retinopathy was detected in 37.8%, pre-proliferative in 1.1% and proliferative retinopathy in 3.8%. Diabetic maculopathy was found in 24.3% of the patients. Laser therapy was considered in 11.4% of the patients due to diabetic retinopathy, and in 14.6% when venous occlusive diseases were included. Two methods, a slit-lamp observation enhanced by a 60D lens and reading from two non-stereo photographs of the posterior pole, were evaluated among 154 patients willing and mentally capable of being examined by either method. The sensitivity of the photographic method was 87/97% (right eye/left eye) when detecting background retinopathy and 81/80% for maculopathy versus 69/61% and 79/63%, respectively, with the slit-lamp method. The photographic method could be applied in 93% of the patients mentally capable of cooperation. Only 5 or 6 patients could be examined per hour with the 60D slit-lamp compared with 30-35 examined by reading retinal photographs. The photographic method is recommended as an easy and reliable screening device for diabetic retinopathy among patients with type II diabetes.
在一项针对II型糖尿病患者的基于人群的研究中，对糖尿病视网膜病变的范围、眼底筛查的必要性以及两种推定筛查方法进行了评估。在已知糖尿病患者群体中，86.9%的患者进行了视网膜评估。检测到背景性糖尿病视网膜病变的比例为37.8%，增殖前期病变为1.1%，增殖性视网膜病变为3.8%。24.3%的患者发现有糖尿病黄斑病变。11.4%的患者因糖尿病视网膜病变而考虑进行激光治疗，若将静脉阻塞性疾病包括在内，则这一比例为14.6%。在154名愿意且有能力接受这两种方法检查的患者中，对两种方法进行了评估，这两种方法分别是使用60D透镜增强的裂隙灯观察法以及阅读两张后极部非立体照片法。在检测背景性视网膜病变时，摄影法的敏感度为87/97%（右眼/左眼），检测黄斑病变时为81/80%，而裂隙灯法分别为69/61%和79/63%。摄影法可应用于93%有能力配合的患者。使用60D裂隙灯每小时只能检查5或6名患者，而阅读视网膜照片每小时可检查30 - 35名患者。推荐摄影法作为II型糖尿病患者糖尿病视网膜病变的一种简便且可靠的筛查手段。
