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首页> 外文期刊>Diabetic medicine: A journal of the British Diabetic Association >Diabetic retinopathy in a remote Indigenous primary healthcare population: a Central Australian diabetic retinopathy screening study in the Telehealth Eye and Associated Medical Services Network project
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Diabetic retinopathy in a remote Indigenous primary healthcare population: a Central Australian diabetic retinopathy screening study in the Telehealth Eye and Associated Medical Services Network project

机译：远程土着原发性医疗人口中的糖尿病视网膜病变：远程医疗和相关医疗服务网络项目中的澳大利亚患糖尿病视网膜病筛查研究

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Abstract Aim To determine diabetic retinopathy prevalence and severity among remote Indigenous Australians. Methods A cross‐sectional diabetic retinopathy screening study of Indigenous adults with Type 2 diabetes was conducted by locally trained non‐ophthalmic retinal imagers in a remote Aboriginal community‐controlled primary healthcare clinic in Central Australia and certified non‐ophthalmic graders in a retinal grading centre in Melbourne, Australia. The main outcome measure was prevalence of any diabetic retinopathy and sight‐threatening diabetic retinopathy. Results Among 301 participants (33% male), gradable image rates were 78.7% ( n = 237) for diabetic retinopathy and 83.1% ( n = 250) for diabetic macular oedema, and 77.7% ( n = 234) were gradable for both diabetic retinopathy and diabetic macular oedema. For the gradable subset, the median (range) age was 48 (19–86) years and known diabetes duration 9.0 (0–24) years. The prevalence of diabetic retinopathy was 47% ( n = 110) and for diabetic macular oedema it was 14.4% ( n = 36). In the fully gradable imaging studies, sight‐threatening diabetic retinopathy prevalence was 16.2% ( n = 38): 14.1% ( n = 33) for clinically significant macular oedema, 1.3% ( n = 3) for proliferative diabetic retinopathy and 0.9% ( n = 2) for both. Sight‐threatening diabetic retinopathy had been treated in 78% of detected cases. Conclusions A novel telemedicine diabetic retinopathy screening service detected a higher prevalence of ‘any’ diabetic retinopathy and sight‐threatening diabetic retinopathy in a remote primary care setting than reported in earlier surveys among Indigenous and non‐Indigenous populations. Whether the observed high prevalence of diabetic retinopathy was attributable to greater detection, increasing diabetic retinopathy prevalence, local factors, or a combination of these requires further investigation and, potentially, specific primary care guidelines for diabetic retinopathy management in remote Australia. Clinical Trials registration number: Australia and New Zealand Clinical Trials Register (ANZCTR): ACTRN 12616000370404.
机译：摘要目的是测定偏远土着澳大利亚人的糖尿病视网膜病变患病率和严重程度。方法采用澳大利亚中南部的偏远原住民社区控制的原发性医疗诊所和视网膜分级中心的偏远原住民对照的原发性医疗诊所，在局部培训的非眼科视网膜成像诊所进行了2型糖尿病的横截面糖尿病视网膜病筛查研究。在澳大利亚墨尔本。主要结果措施是患有任何糖尿病视网膜病变和威胁性糖尿病患者视网膜病变的患病率。结果在301名参与者（33％男性）中，糖尿病视网膜病变为78.7％（n = 237），糖尿病黄斑水肿的83.1％（n = 250），77.7％（n = 234）糖尿病患者视网膜病变和糖尿病黄斑水肿。对于渐变子集，中位数（范围）年龄为48（19-86）岁，已知糖尿病持续时间9.0（0-24）年。糖尿病视网膜病变的患病率为47％（n = 110），对于糖尿病性黄斑水肿为14.4％（n = 36）。在完全渐进的成像研究中，威胁性糖尿病视网膜病变患病率为16.2％（n = 38）：14.1％（n = 33），用于临床显着的黄斑水肿，1.3％（n = 3）用于增殖性糖尿病视网膜病变，0.9％（ n = 2）对于两者。威胁威胁的糖尿病视网膜病变已经在78％的检测病例中治疗。结论一种新型远程尿液糖尿病视网膜病筛查服务检测到偏远初级护理环境中的“任何”糖尿病视网膜病变和威胁毒性糖尿病视网膜病变的患病率高于本土和非土着人群的早期调查中的遗传初级保健环境。观察到的糖尿病视网膜病变的高患病率是否应归因于更大的检测，增加糖尿病视网膜病变，局部因素或这些组合需要进一步调查，并且可能是偏远澳大利亚患有糖尿病视网膜病理管理的进一步调查。临床试验登记号码：澳大利亚和新西兰临床试验登记册（ANZCTR）：ACTRN 12616000370404。

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