Toy Brian C, Aguinaldo Tyler, Eliason Joseph, Egbert James
Ophthalmic Surg Lasers Imaging Retina. 2016 Jul 1;47(7):636-42. doi: 10.3928/23258160-20160707-05.
To compare nonmydriatic fundus photography (nFP) screening for diabetic retinopathy (DR) with clinical dilated fundus examination (DFE) in a safety-net setting.
This was a retrospective, institutional cohort study of 6,911 patients undergoing nFP screening for DR between 2008 and 2012. A subset of 1,521 patients underwent DFE, and clinical DR grade was compared with nFP DR grade.
nFP screening demonstrated 17% prevalence of any DR, with moderate nonproliferative diabetic retinopathy (NPDR) or worse present in 5% of patients. Thirteen percent of photos were unreadable. When compared with DFE, sensitivity and specificity of nFP to detect moderate NPDR or worse were 91% and 97%, respectively. Area under the receiver operating characteristic curve was 0.97.
The authors' study found 17% of patients screened with nFP had referral-warranted DR. These results demonstrate a use-case of telemedicine to screen large numbers of patients in a safety-net setting, but they also highlight the need for adequate specialty resources to care for referred patients. [Ophthalmic Surg Lasers Imaging Retina. 2016;47:636-642.].
在安全网环境下，比较免散瞳眼底照相术（nFP）筛查糖尿病视网膜病变（DR）与临床散瞳眼底检查（DFE）的效果。
这是一项回顾性的机构队列研究，研究对象为2008年至2012年间接受nFP筛查DR的6911例患者。1521例患者的子集接受了DFE，并将临床DR分级与nFP DR分级进行比较。
nFP筛查显示任何DR的患病率为17%，5%的患者存在中度非增殖性糖尿病视网膜病变（NPDR）或更严重病变。13%的照片不可读。与DFE相比，nFP检测中度NPDR或更严重病变的敏感性和特异性分别为91%和97%。受试者操作特征曲线下面积为0.97。
作者的研究发现，接受nFP筛查的患者中有17%患有需要转诊的DR。这些结果证明了远程医疗在安全网环境下筛查大量患者的应用案例，但也凸显了需要有足够的专科资源来治疗转诊患者。[《眼科手术、激光与视网膜影像》。2016；47：636 - 642。]
