Al-Rashidi Sultan H, Al-Thunayyan Faris S, Alsuhaibani Khalid A, Alharbi Abdulmajeed A, Alharbi Khalid A
Department of Ophthalmology, College of Medicine, Qassim University, Buraidah, Saudi Arabia.
SAGE Open Med. 2020 Jan 15;8:2050312119900863. doi: 10.1177/2050312119900863. eCollection 2020.
Blindness is one of the most widespread final pathways of diabetic retinopathy and its associated diabetic macular edema. The general practitioners are the first to encounter these diabetic patients. Fundoscopy is now considered as an ideal way for the diagnosis of patients with diabetic retinopathy. Therefore, this study was undertaken to know the ability and skills of general practitioners for the diagnosis and management of patients with diabetic retinopathy and diabetic macular edema.
This study was conducted in all major cities in Qassim province of Saudi Arabia during January to May 2017. A validated questionnaire was used to assess the general practitioners' knowledge and practice for the management of diabetic retinopathy and diabetic macular edema. Questions related to referrals, diagnosis, and treatment options to diabetic retinopathy and diabetic macular edema were asked to the general practitioners.
Of 96 general practitioners, 76 returned the questionnaire with a response rate of 79.2%. Only 26.3% general practitioners referred patients with type 1 diabetes to ophthalmologists as per guidelines set by the American Academy of Ophthalmology, whereas 74% of general practitioners showed good knowledge for referring patients with type 2 diabetes to ophthalmology clinics. Lack of knowledge was also noticed for the treatment of diabetic retinopathy, as only 36.8% of general practitioners replied positive for dilated fundus examination option, whereas 78.9% of general practitioners chose laser photocoagulation as a treatment option. Similar response from them was observed for patients with diabetic macular edema. Furthermore, data also showed years in practice of general practitioners was well correlated with their knowledge for the management of diabetic retinopathy and diabetic macular edema.
The general practitioners included in this study showed lack of knowledge in handling patients with diabetic retinopathy and diabetic macular edema. Therefore, refresher courses are needed that highlight the acquisition of their skills in fundoscopy.
失明是糖尿病视网膜病变及其相关糖尿病性黄斑水肿最常见的最终结局之一。全科医生是首批接诊这些糖尿病患者的人。眼底镜检查目前被认为是诊断糖尿病视网膜病变患者的理想方法。因此，开展本研究以了解全科医生诊断和管理糖尿病视网膜病变及糖尿病性黄斑水肿患者的能力与技能。
本研究于2017年1月至5月在沙特阿拉伯卡西姆省的所有主要城市进行。使用经过验证的问卷来评估全科医生对糖尿病视网膜病变和糖尿病性黄斑水肿管理的知识与实践。向全科医生询问了与糖尿病视网膜病变和糖尿病性黄斑水肿的转诊、诊断及治疗选择相关的问题。
96名全科医生中，76人返回了问卷，回复率为79.2%。按照美国眼科学会制定的指南，只有26.3%的全科医生将1型糖尿病患者转诊至眼科医生处，而74%的全科医生在将2型糖尿病患者转诊至眼科诊所方面表现出良好的知识水平。在糖尿病视网膜病变的治疗方面也发现存在知识欠缺，只有36.8%的全科医生对散瞳眼底检查选项回答正确，而78.9%的全科医生选择激光光凝作为治疗选项。对于糖尿病性黄斑水肿患者，他们给出了类似的回答。此外，数据还显示全科医生的从业年限与他们对糖尿病视网膜病变和糖尿病性黄斑水肿管理的知识水平密切相关。
本研究纳入的全科医生在处理糖尿病视网膜病变和糖尿病性黄斑水肿患者方面知识欠缺。因此，需要开展进修课程，重点提高他们在眼底镜检查方面的技能。
