Detection of perimacular red dots and blots when screening for diabetic retinopathy: Refer or not refer?

Diabetes & Vascular Disease Research : Official Journal of the International Society of Diabetes and Vascular Disease
Anatolie BaltatescuMassimo Porta

Abstract

Detection of microaneurysms and/or microhaemorrhages near the fovea when screening for diabetic retinopathy poses a problem because referral to retinal specialists may alarm patients and unnecessarily burden ophthalmologists. Six-month prospective study of patients found to have minimal red lesions within one disc diameter of the fovea when screened for diabetic retinopathy. Two 45° digital photographs, one centred on the macula and the other nasal including the optic disc, were taken for each eye. All patients received a 6-month re-screening appointment. Out of 70 patients, 41 returned for re-screening. Diabetic retinopathy had worsened in 3 who required referral but no treatment, was unchanged in 19 and was undetectable in the other 19. Haemoglobin A1c decreased from 7.76% ± 1.50% (61.3 ± 16.2 mmol/mol) to 6.93% ± 1.7% (52.3 ± 18.9 mmol/mol) in the patients in whom diabetic retinopathy worsened but did not change in the other groups. Baseline haemoglobin A1c ( p = 0.048) and systolic blood pressure ( p = 0.007) were lower in the patients in whom diabetic retinopathy improved, but a multivariate model including haemoglobin A1c, blood pressure and known disease duration could not identify any independent risk factor. Minimal re...Continue Reading

References

Feb 1, 1997·Diabetic Medicine : a Journal of the British Diabetic Association·M HenricssonL Groop
Jan 19, 2008·Diabetic Medicine : a Journal of the British Diabetic Association·C J SchofieldG P Leese
Feb 4, 2012·Diabetes Care·Joanne W Y YauUNKNOWN Meta-Analysis for Eye Disease (META-EYE) Study Group
Feb 23, 2017·Diabetes Care·Sharon D SolomonThomas W Gardner

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