Assessment of retinopathy in diabetics newly referred to the diabetic clinic
โ Scribed by Moriarty, A P ;Shilling, J S ;Williams, C D ;Smith, S A ;Lowy, C
- Publisher
- John Wiley and Sons
- Year
- 1993
- Tongue
- English
- Weight
- 349 KB
- Volume
- 10
- Category
- Article
- ISSN
- 1357-8170
No coin nor oath required. For personal study only.
โฆ Synopsis
Abstract
Delay in referral of patients with significant diabetic retinopathy by the diabetic physician to the ophthalmologist may compromise visual outcome. We prospectively audited the ophthalmic assessment of 37 newly referred diabetic patients to the diabetic clinic. Unbeknown to the diabetologist, patients underwent retinal photography with review of photographs by a consultant ophthalmologist and finally another examination with slitโlamp biomicroscopy by an independent ophthalmologist as โgold standardโ. Maculopathy present in 12 of 74 eyes was missed on seven occasions by the diabetic physician and on one occasion by photography (p<0.03 McNemar's test; confidence intervals โ15.2% โ72.3% physicians, 61.5 โ99.8% photography). Inaccuracies in visual acuity measurement and inconsistencies in pupil dilation were noted. Retinal photography may provide a superior means for detection of maculopathy in the newly referred diabetic than assessment by the diabetic physician.
๐ SIMILAR VOLUMES
## Abstract The diagnostic value of peripheral retinal photography in screening for retinopathy was assessed in 100 eyes from 95 diabetic patients following pharmacological mydriasis. Polaroid prints of the central 45ยฐ field and of 4 peripheral fields were assessed by a consultant ophthalmologist.
Management decisions for patients with diabetic eye disease can remain difยฎcult despite the presence of guidelines. The cases below illustrate the dilemmas about the timing of instituting insulin in patients needing laser photocoagulation for improvement of glycaemic control. The use of angiotensin-
To describe the course and risk factors for development and progression of retinopathy, we studied a cohort of 333 Israeli Jewish patients with Type 1 (insulin-dependent) diabetes mellitus. The median age at diagnosis was 9.5 (range 0.04-26.2) years and the median duration of follow-up was 14 (range