J Telemed Telecare - Diabetic retinopathy screening using tele-ophthalmology in a primary care setting.

Tópicos

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Resumo

We evaluated tele-ophthalmology for diabetic retinopathy screening in a primary care setting. Four general practitioners (GPs) were taught to assess non-mydriatic retinography images of patients with diabetes. After training, a total of 1223 patients were screened using this method: 926 (76%) did not have diabetic retinopathy and 297 (24%) were referred for an ophthalmologic assessment. Of the 297 patients, 186 (15%) did not have diabetic retinopathy and were considered to be false positives, 85 (7%) had diabetic retinopathy and in 26 cases (2%) the retinography images were unreadable. The specificity of GPs for detecting diabetic retinopathy by non-mydriatic retinography was 83%. Ophthalmologists also assessed 120 patients who had been diagnosed as normal to detect false negatives. Ten patients (8.3%) had mild non-proliferative diabetic retinopathy with small isolated retinal hemorrhages. Only one patient (0.8%) had treatable diabetic retinopathy with hard exudates and microaneurysms. The sensitivity of GPs for detecting diabetic retinopathy was 90.9%; the sensitivity for detecting treatable lesions was 99.2%. We concluded that adequately trained GPs can screen for treatable lesions of diabetic retinopathy with a very high level of reliability using non-mydriatic retinography.

Resumo Limpo

evalu teleophthalmolog diabet retinopathi screen primari care set four general practition gps taught assess nonmydriat retinographi imag patient diabet train total patient screen use method diabet retinopathi refer ophthalmolog assess patient diabet retinopathi consid fals posit diabet retinopathi case retinographi imag unread specif gps detect diabet retinopathi nonmydriat retinographi ophthalmologist also assess patient diagnos normal detect fals negat ten patient mild nonprolif diabet retinopathi small isol retin hemorrhag one patient treatabl diabet retinopathi hard exud microaneurysm sensit gps detect diabet retinopathi sensit detect treatabl lesion conclud adequ train gps can screen treatabl lesion diabet retinopathi high level reliabl use nonmydriat retinographi

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