评估光学相干断层扫描在对原住民群体进行糖尿病视网膜病变筛查中的影响。
Evaluating the impact of optical coherence tomography in diabetic retinopathy screening for an Aboriginal population.
机构信息
Lions Outback Vision, Perth, Western Australia, Australia.
The University of Western Australia, Perth, Western Australia, Australia.
出版信息
Clin Exp Ophthalmol. 2018 Mar;46(2):116-121. doi: 10.1111/ceo.13018. Epub 2017 Aug 11.
IMPORTANCE
Optical coherence tomography is used routinely in management of diabetic eye disease but has not been evaluated in Australian outreach settings for screening programmes.
BACKGROUND
The study aims to evaluate the use of optical coherence tomography combined with a fundus camera compared with a fundus camera only in a telehealth diabetic retinopathy screening programme for Aboriginal Australians.
DESIGN
Retrospective comparative study was used.
PARTICIPANTS
The study included patients with diabetes at two Aboriginal Health Services.
METHODS
An intervention group was studied in 2015 using a Topcon 3D optical coherence tomography-1 Maestro combined with optical coherence tomography/fundus camera. A control group was studied in 2014 using a DRS non-mydriatic fundus camera. Fundus photographs were emailed to trained retinal graders for review. Optical coherence tomography scans were graded by ophthalmologists via remote TeamViewer access.
MAIN OUTCOME MEASURE
Referral rates to an eye health professional and the rate of inadequate photographs.
RESULTS
Two hundred and twenty-two patients were included, with 80 in the control group and 142 in the intervention group. There was a significantly higher rate of inadequate fundus photographs in the intervention group (31.0% vs. 13.8%). Although there was a higher rate of referral to an eye health professional in the intervention group (39.6% vs. 30.0%), this was not significant. Diabetic retinopathy and maculopathy was evident in 32.3% and 12.0% of adequate fundus photographs, respectively. Diabetic macular oedema was present in 3.6% of optical coherence tomography scans.
CONCLUSIONS AND RELEVANCE
The combined optical coherence tomography fundus camera provided no advantage for diabetic retinopathy screening compared with fundus photography in an Australian programme. The rate of referral to an eye health professional was not reduced with a higher rate of inadequate fundus photographs.
重要性
光学相干断层扫描（OCT）常用于糖尿病眼病的管理，但尚未在澳大利亚外展筛查项目中对其进行评估。
背景
本研究旨在评估在澳大利亚原住民的远程医疗糖尿病视网膜病变筛查项目中，与单独使用眼底相机相比，联合使用眼底相机和光学相干断层扫描仪（OCT）的效果。
设计
回顾性比较研究。
参与者
研究纳入了两家原住民健康服务机构的糖尿病患者。
方法
在 2015 年，实验组使用 Topcon 3D OCT-1 Maestro 与 OCT/眼底相机联合进行检测；对照组在 2014 年使用 DRS 非散瞳眼底相机进行检测。将眼底照片通过电子邮件发送给经过培训的视网膜分级医师进行评估。OCT 扫描则由眼科医生通过远程 TeamViewer 访问进行分级。
主要观察指标
转诊至眼科医生的比例和照片不足的比例。
结果
共纳入 222 例患者，其中对照组 80 例，实验组 142 例。实验组的眼底照片不足比例明显更高（31.0%比 13.8%）。尽管实验组转诊至眼科医生的比例更高（39.6%比 30.0%），但差异无统计学意义。在充足的眼底照片中，分别有 32.3%和 12.0%的患者出现糖尿病性视网膜病变和黄斑病变。OCT 扫描显示，有 3.6%的患者存在糖尿病性黄斑水肿。
结论和相关性
在澳大利亚的筛查项目中，与眼底摄影相比，联合 OCT 眼底相机并未为糖尿病视网膜病变筛查带来优势。尽管眼底照片不足的比例更高，但转诊至眼科医生的比例并未降低。
Zotero 插件