2年远程筛查随访糖尿病视网膜病变社区患者的研究

A two-year follow-up study on remote screening for diabetic retinopathy in community patients

目的评估社区糖尿病视网膜病变(DR)的远程筛查及2年随访的可行性。方法本研究为横断面研究。以免散瞳数码眼底照相机和计算机网络技术为基础,构建社区DR远程筛查随访系统。2013年7月至2015年7月北京德胜社区卫生服务中心管理的糖尿病患者数1 508例(3 016只眼)进行视力检查、DR诊断及随诊率进行评估。结果社区检查人员与专业检查人员的视力检查结果比较,差异无统计学意义(P=0.78)。采用传统检查法与眼底照相法诊断,两者间诊断比较的kappa值为0.92;第二年患者随访率为72%,与第一年的首诊率差异无统计学意义(P=0.80)。结论社区DR远程筛查系统可满足DR患者筛查及随访的需求。

Objective To evaluate the feasibility of remote screening for diabetic retinopathy （DR） in the com-munity level through a 2-year follow-up. Methods This was a cross-sectional study using an established community DR remote screening and follow-up system based on non-mydriatic fundus photography and computer networking. Be-tween July 2013 and July 2015, 1 508 subjects （3 016 eyes） registered to Beijing Desheng Community Health Services received visual examination, DR diagnostic screening, and were evaluated for compliance to follow-up. Results There was no statistically significant difference in results of visual examination conducted by community health work-ers vs professionalists （P=0.78）. Good coincidence in diagnostic performance for DR was found between the classic method and fundus photography （kappa=0.92）. The second-year rate of patient follow-up was 72%, which was compa-rable with the rate of first-year diagnosis （P=0.80）. Conclusion Community remote screening system may meet the need for remote DR screening and follow-up of patients.