Department of Optometry and Vision Sciences, The University of Melbourne, Parkville, Victoria, Australia.
Ophthalmic Physiol Opt. 2021 Jul;41(4):885-895. doi: 10.1111/opo.12798. Epub 2021 Mar 8.
Contemporary eye care increasingly recommends the use of advanced retinal imaging technology. Anecdotal evidence suggests that this equipment is widely available in primary eye care settings; however, knowledge regarding how optometrists use this equipment in the context of diabetic retinopathy (DR) is limited. This study aimed to obtain a current overview of optometrists' clinical practice behaviours in the detection, screening, diagnosis and management of patients with diabetes.
A cross-sectional survey was designed to evaluate optometrists' self-reported clinical practice patterns and perceptions, as well as the availability and impact of retinal imaging equipment specific to DR and diabetic macular oedema (DMO) on optometrists' clinical practice. The survey invited participation from all optometrists practising in Australia.
One hundred and sixty-seven optometrists participated. Optometrists' self-reported confidence in assessing DR and DMO was high. Optometrists' referral patterns considered the severity of DR and DMO before initiating referral to secondary ophthalmology care. Nearly all optometrists (98.8%) indicated that they had some form of retinal imaging equipment available to them in clinical practice. An optical coherence tomography (OCT) device was available to 75.5% of optometrists. A significant association between having an OCT device in the practice and higher self-reported confidence levels in the assessment of DMO was found.
Many optometrists are well equipped with sophisticated retinal imaging technology for the provision of high-quality eye care. Enhancing optometric training and education programmes can maximise the community benefit of access to this equipment and improve delivery of eye care in the community.
当代眼保健越来越推荐使用先进的视网膜成像技术。有传闻证据表明，这种设备在初级眼科保健环境中广泛可用；然而，关于验光师如何在糖尿病视网膜病变（DR）的背景下使用这种设备的知识有限。本研究旨在获得验光师在检测、筛查、诊断和管理糖尿病患者方面的临床实践行为的最新概述。
设计了一项横断面调查，以评估验光师自我报告的临床实践模式和观念，以及特定于 DR 和糖尿病性黄斑水肿（DMO）的视网膜成像设备的可用性和对验光师临床实践的影响。该调查邀请澳大利亚所有执业验光师参与。
167 名验光师参与了调查。验光师自我报告评估 DR 和 DMO 的信心很高。验光师的转诊模式在开始向二级眼科护理转诊之前考虑了 DR 和 DMO 的严重程度。几乎所有验光师（98.8%）表示，他们在临床实践中都有某种形式的视网膜成像设备。75.5%的验光师拥有光学相干断层扫描（OCT）设备。在实践中拥有 OCT 设备与自我报告评估 DMO 的信心水平较高之间存在显著关联。
许多验光师都配备了先进的视网膜成像技术，以提供高质量的眼保健。加强验光师培训和教育计划可以最大限度地发挥社区获得这种设备的效益，并改善社区眼保健服务的提供。
