Chen Andrew X, Hsueh Jessica, Han Michael M, Conti Thais F, Conti Felipe F, Immler Wes K, Babiuch Amy S, Singh Rishi P
Ophthalmic Surg Lasers Imaging Retina. 2019 Oct 1;50(10):608-612. doi: 10.3928/23258160-20191009-02.
To analyze the examination practices and referral of patients with diabetic retinopathy (DR) by optometrists in routine clinical care.
Diabetic patient records from 2012 to 2018 were retrospectively reviewed for documentation of dilated fundus exam (DFE), imaging, follow-up appointments, and referrals. Concordance between clinical exam and coding was also analyzed.
For 97.8% of encounters, DFE was performed, the patient was referred for DFE, or DFE was scheduled for follow-up. When DFE was performed at the initial visit, this resulted in referral of 19.8% of patients to an ophthalmologist. Imaging was obtained occasionally, with fundus photos in 2.6% and optical coherence tomography in 14.5% of encounters. Concordance of DR grading between exam and coding was 78.8%. Recommended follow-up times were incorrect based on DR severity level in 13.8% of encounters.
Although DFE was performed reliably by optometrists, utilization of imaging, DR grading and coding, and appropriate follow-up periods could be improved. [Ophthalmic Surg Lasers Imaging Retina. 2019;50:608-612.].
分析验光师在日常临床护理中对糖尿病视网膜病变（DR）患者的检查操作及转诊情况。
回顾性分析2012年至2018年糖尿病患者记录，以获取散瞳眼底检查（DFE）、影像学检查、随访预约及转诊的记录。还分析了临床检查与编码之间的一致性。
在97.8%的诊疗过程中，进行了DFE、患者被转诊进行DFE或DFE被安排随访。初次就诊时进行DFE检查后，19.8%的患者被转诊至眼科医生处。偶尔进行影像学检查，2.6%的诊疗过程中拍摄了眼底照片，14.5%的诊疗过程中进行了光学相干断层扫描。检查与编码之间DR分级的一致性为78.8%。13.8%的诊疗过程中，根据DR严重程度水平推荐的随访时间不正确。
尽管验光师能可靠地进行DFE检查，但影像学检查的应用、DR分级与编码以及适当的随访时间仍有待改进。[《眼科手术、激光与视网膜成像》。2019；50：608 - 612。]
