de Sonnaville J J, van der Feltz van der Sloot D, Ernst L, Wijkel D, Heine R J
Diabet Med. 1996 May;13(5):482-6. doi: 10.1002/(SICI)1096-9136(199605)13:5<482::AID-DIA95>3.0.CO;2-I.
The purpose of the study was to assess the reliability of mydriatic 60 degrees fundus photography in a retinopathy screening programme for Type 2 diabetic patients in a primary health care setting. In 323 eligible consecutive Type 2 diabetic patients above 40 years of age, attending a regional shared care diabetes project, mydriatic wide angle fundus photography was compared with standardized fundoscopy in dilated pupils as the recommended test for the detection of diabetic retinopathy. Fundus photography included two black and white transparencies per eye visualizing the central and nasal retinal field. Fundoscopy findings and pictures were scored according to modified Wisconsin criteria. Fundoscopy revealed in 95/646 eyes (14.7%) some degree of diabetic retinopathy. Sensitivity and specificity of fundus photography (omitting ungradable transparencies) were 97% for the diagnosis of any diabetic retinopathy (DRP). All patients with moderate and severe DRP (Wisconsin grade 3 and worse) according to fundoscopy were detected by fundus photography. In conclusion, mydriatic wide angle 60 degrees fundus photography, making two pictures per eye, can be applied effectively and reliably in the detection of diabetic retinopathy in patients with Type 2 diabetes.
本研究的目的是评估在基层医疗环境中，对2型糖尿病患者进行视网膜病变筛查项目时，散瞳60度眼底摄影的可靠性。在参加一个地区共享护理糖尿病项目的323例符合条件的40岁以上连续2型糖尿病患者中，将散瞳广角眼底摄影与散瞳后标准化检眼镜检查作为检测糖尿病视网膜病变的推荐检查方法进行比较。眼底摄影包括每只眼睛两张黑白透明片，可显示视网膜中央和鼻侧区域。根据改良的威斯康星标准对检眼镜检查结果和图片进行评分。检眼镜检查发现95/646只眼睛（14.7%）有某种程度的糖尿病视网膜病变。眼底摄影（不包括无法分级的透明片）对任何糖尿病视网膜病变（DRP）诊断的敏感性和特异性为97%。根据检眼镜检查，所有患有中度和重度DRP（威斯康星分级3级及以上）的患者均被眼底摄影检测出。总之，每只眼睛拍摄两张照片的散瞳广角60度眼底摄影可有效且可靠地应用于2型糖尿病患者糖尿病视网膜病变的检测。
