Forrest R D, Jackson C A, Yudkin J S
Diabetes Res. 1987 May;5(1):39-42.
The efficacy of diabetic retinal screening by a nurse trained in ophthalmoscopy and of a diabetologist was assessed by comparison with fundal photography. The study was performed in 282 subjects, 59 with known diabetes and 223 participating in a screening survey, of whom 13 had diabetes and 43 impaired glucose tolerance. The prevalence of retinopathy in the diabetic subjects was 36.8% and serious retinopathy 9.5% while in the screened subjects it was 3.5% and 0.9% respectively. The characteristics of nurse examination as a test to detect retinopathy was: sensitivity 50.0% +/- CL16.8%, specificity 99.2% +/- CL0.9%, which compared with 51.3% +/- CL15.7% and 98.7% +/- CL1.2% for the doctor. The nurse failed to detect serious retinopathy as accurately as the doctor, although new vessels were missed in 5 of 6 cases by the doctor. Screening for retinopathy requires either ophthalmoscopy by an observer trained to a higher level than is common in doctors, or non-mydriatic retinal photography.
通过眼底镜检查培训的护士和糖尿病专科医生进行糖尿病视网膜筛查的效果，与眼底摄影进行了比较评估。该研究在282名受试者中进行，其中59名患有已知糖尿病，223名参与筛查调查，其中13名患有糖尿病，43名糖耐量受损。糖尿病受试者中视网膜病变的患病率为36.8%，严重视网膜病变为9.5%，而在筛查受试者中分别为3.5%和0.9%。护士检查作为检测视网膜病变的一项测试的特征为：敏感性50.0%±可信区间16.8%，特异性99.2%±可信区间0.9%，而医生的相应数据为51.3%±可信区间15.7%和98.7%±可信区间1.2%。护士检测严重视网膜病变的准确性不如医生，尽管医生在6例中有5例漏诊了新生血管。视网膜病变筛查需要由接受过比普通医生更高水平培训的观察者进行眼底镜检查，或者采用非散瞳视网膜摄影。
