Roser Pia, Kalscheuer Hannes, Groener Jan B, Lehnhoff Daniel, Klein Roman, Auffarth Gerd U, Nawroth Peter P, Schuett Florian, Rudofsky Gottfried
Department of Medicine I and Clinical Chemistry, University Hospital Heidelberg, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany; Department of Endocrinology and Diabetology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246 Hamburg, Germany.
Department of Medicine I and Clinical Chemistry, University Hospital Heidelberg, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany.
J Diabetes Res. 2016;2016:4101890. doi: 10.1155/2016/4101890. Epub 2016 Jan 21.
To evaluate the effect of onsite screening with a nonmydriatic, digital fundus camera for diabetic retinopathy (DR) at a diabetes outpatient clinic.
This cross-sectional study included 502 patients, 112 with type 1 and 390 with type 2 diabetes. Patients attended screenings for microvascular complications, including diabetic nephropathy (DN), diabetic polyneuropathy (DP), and DR. Single-field retinal imaging with a digital, nonmydriatic fundus camera was used to assess DR. Prevalence and incidence of microvascular complications were analyzed and the ratio of newly diagnosed to preexisting complications for all entities was calculated in order to differentiate natural progress from missed DRs.
For both types of diabetes, prevalence of DR was 25.0% (n = 126) and incidence 6.4% (n = 32) (T1DM versus T2DM: prevalence: 35.7% versus 22.1%, incidence 5.4% versus 6.7%). 25.4% of all DRs were newly diagnosed. Furthermore, the ratio of newly diagnosed to preexisting DR was higher than those for DN (p = 0.12) and DP (p = 0.03) representing at least 13 patients with missed DR.
The results indicate that implementing nonmydriatic, digital fundus imaging in a diabetes outpatient clinic can contribute to improved early diagnosis of diabetic retinopathy.
评估在糖尿病门诊使用免散瞳数字眼底相机进行糖尿病视网膜病变（DR）现场筛查的效果。
这项横断面研究纳入了502例患者，其中112例为1型糖尿病患者，390例为2型糖尿病患者。患者接受了微血管并发症筛查，包括糖尿病肾病（DN）、糖尿病多发性神经病变（DP）和DR。使用数字免散瞳眼底相机进行单视野视网膜成像以评估DR。分析微血管并发症的患病率和发病率，并计算所有类型新诊断并发症与既往存在并发症的比例，以区分自然进展与漏诊的DR。
对于两种类型的糖尿病，DR的患病率均为25.0%（n = 126），发病率为6.4%（n = 32）（1型糖尿病与2型糖尿病：患病率：35.7%对22.1%，发病率5.4%对6.7%）。所有DR中有25.4%为新诊断病例。此外，新诊断DR与既往存在DR的比例高于DN（p = 0.12）和DP（p = 0.03），这表明至少有13例DR漏诊。
结果表明，在糖尿病门诊实施免散瞳数字眼底成像有助于改善糖尿病视网膜病变的早期诊断。
