Estudio Granada sobre retinopatía diabéticaCribado de 8.244 pacientes diabéticos. I

  1. J.L. García-Serrano
  2. D. Serrano-Laborda
  3. M. López-Pozas
  4. C. Cabello-Aparicio
  5. L. Castro-Rosales
Revista:
Archivos de la Sociedad Española de Oftalmologia

ISSN: 0365-6691

Año de publicación: 2007

Volumen: 82

Número: 11

Páginas: 681-689

Tipo: Artículo

DOI: 10.4321/S0365-66912007001100006 DIALNET GOOGLE SCHOLAR lock_openAcceso abierto editor

Otras publicaciones en: Archivos de la Sociedad Española de Oftalmologia

Objetivos de desarrollo sostenible

Resumen

Objectives: To evaluate the results of regular screening for diabetic retinopathy in the geographic area assigned to the San Cecilio University Hospital of Granada. Material and methods: A multicenter prospective cohort study was carried out over a 2-year follow-up period. Retinal examinations were performed in 8244 diabetics in 14 health centres. 11,924 retinal examinations using an indirect ophthalmoscope, following pupil dilatation, were carried out. The classification of the lesions was as recommended by the simplified international scale of diabetic retinopathy and macular edema. The intervals between fundus examinations followed those recommented by the etdrs. Results: The crude prevalence of diabetes in the health area concerned was 2.77%. The average screening compliance of the program was 84.1%, and in only 0.3% of the patients was the fundus ophthalmoscopy ungradable. 91.3% of the known diabetic population attended for at least one fundus examination, with only 3.4% of the patients being referred for hospital treatment. The annual cost of the program was set at 53,173 euros, with the average cost of each examination (6000 per year) being 8.87 euros. Conclusions: The Diabetic Retinopathy Screening Program (through dilated pupils) carried out with indirect ophthalmoscopy is cost-effective. It provides coverage to the whole known diabetic population with a high level of compliance. The percentage of patients whose fundus can be considered ungradable is minimal.

Referencias bibliográficas

  • Fernández Fernández, I, Aguilar Diosdado, M, Amaya Baro, ML, Barrigüete Andreu, MI, Benito López, P, Cornejo Castillo, M. (2002). Diabetes Mellitus tipo 1: Proceso asistencial integrado. Consejería de Salud. Sevilla.
  • Fernández Fernández, I, Aguilar Diosdado, M, Amaya Baro, ML, Barrigüete Andréu, MI, Benito López, P, Cornejo Castillo, M. (2002). Diabetes Mellitus tipo 2: Proceso asistencial integrado. Consejería de Salud. Sevilla.
  • (2005). Plan integral de Diabetes: Programa de detección precoz de la retinopatía diabética. 1-26
  • (2005). Plan Integral de Diabetes: Cribado de la retinopatía diabética con retinografía digital en Atención Primaria. Test de Autoevaluación. 1-31
  • Stefansson, E. (2004). Man versus machine: Is technology a blessing or a barrier in screening for diabetic eye disease?. Acta Ophthalmol Scand. 82. 643-644
  • Tubbs, CG, Safeek, A, Mayo, HG, Markova, T. (2004). Clinical inquiries: Do routine eye exams reduce occurrence of blindness from type 2 diabetes?. J Fam Pract. 53. 732-734
  • (1983). Photocoagulation for diabetic maculopathy: A randomized controlled clinical trial using the xenon arc. British Multicentre Study Group Diabetes. 32. 1010-1016
  • Wilkinson, CP, Ferris, FL 3rd, Klein, RE, Lee, PP, Agardh, CD, Davis, M. (2003). Proposed international clinical diabetic retinopathy and diabetic macular edema disease severity scales. Ophthalmology. 110. 1677-1682
  • (1991). Fundus photographic risk factors for progression of diabetic retinopathy: ETDRS report number 12. Early Treatment Diabetic Retinopathy Study Research Group Ophthalmology. 98. 823-833
  • López-Gálvez, MI. (2004). Escala internacional de severidad de la retinopatía y del edema macular diabético. Arch Soc Esp Oftalmol. 79. 149-150
  • Fong, DS, Aiello, LP, Ferris, FL 3rd, Klein, R. (2004). Diabetic retinopathy. Diabetes Care. 27. 2540-2553
  • Faria-Abreu, JR. (2006). Retinopatía diabética. 1. MacLine. Madrid.
  • Bonafonte, S, García, CA, Davis, MD. (2006). Retinopatía diabética. 2. Elsevier. Madrid.
  • Teruel-Maicas, C, Fernández-Real, JM, Ricart, W, Valent Ferrer, R, Vallés Prats, M. (2005). Prevalencia de la retinopatía diabética en la población de diabéticos diagnosticados en las comarcas de Girona: Estudio de los factores asociados. Arch Soc Esp Oftalmol. 80. 85-91
  • Santos-Bueso, E, Fernández-Vigo, J, Fernández Pérez, C, Macarro Merino, A, Fernández Perianes, J. (2005). Prevalencia de retinopatía diabética en la comunidad Autónoma de Extremadura: 1997-2001 (Proyecto Extremadura para prevención de la ceguera). Arch Soc Esp Oftalmol. 80. 187-194
  • Romero-Aroca, P, Fernández-Alart, J, Baget-Bernaldiz, M, Méndez-Marín, I, Salvat-Serra, M. (2007). Epidemiología de la retinopatía diabética en pacientes tipo II: Cambios observados en una población entre los años 1993 y 2005, tras los nuevos criterios diagnósticos y un mayor control de los pacientes. Arch Soc Esp Oftalmol. 82. 209-218
  • Kempen, JH, O´Colmain, BJ, Leske, MC, Haffner, SM, Klein, R, Moss, SE. (2004). The prevalence of diabetic retinopathy among adults in the United States. Arch Ophthalmol. 122. 552-563
  • Harvey, JN, Craney, L, Nagendran, S, Ng, CS. (2006). Towards comprehensive population-based screening for diabetic retinopathy: operation of the North Wales diabetic retinopathy screening programme using a central patient register and various screening methods. J Med Screen. 13. 87-92
  • Lopez-Bastida, J, Cabrera-Lopez, F, Serrano-Aguilar, P. (2007). Sensitivity and specificity of digital retinal imaging for screening diabetic retinopathy. Diabet Med. 24. 403-407
  • Agarwal, S, Mahajan, S, Rani, PK, Raman, R, Paul, PG, Kumaramanickavel, G. (2005). How high is the non-response rate of patients referred for eye examination from diabetic screening camps?. Ophthalmic Epidemiol. 12. 393-394
  • Sinclair, SH. (2006). Diabetic retinopathy: the unmet needs for screening and a review of potential solutions. Expert Rev Med Dev. 3. 301-313
  • Henahan, S. (2007). Remote diabetic retinopathy screening reaches those most at risk. Eurotimes. 12. 10
  • Soulie-Strougar, M, Charles, A, Metral, P, Quercia, P, Souchier, M, Chirpaz, L. (2007). Dépistage de la rétinopathie diabétique en Bourgogne par un rétinographe non mydriatique itinerant. J Fr Opthalmol. 30. 121-126
  • Boucher, MC, Nguyen, QT, Angioi, K. (2005). Mass community screening for diabetic retinopathy using a nonmydriatic camera with telemedicine. Can J Ophthalmol. 40. 734-742
  • Murgatroyd, H, Ellingford, A, Cox, A, Binnie, M, Ellis, JD, MacEwen, CJ. (2004). Effect of mydriasis and different field strategies on digital image screening of diabetic eye disease. Br J Ophthalmol. 88. 920-924
  • Saari, JM, Summanen, P, Kivela, T, Saari, KM. (2004). Sensitivity and specificity of digital retinal images in grading diabetic retinopathy. Acta Ophthalmol Scand. 82. 126-130
  • Knudtson, MD, Klein, BE, Klein, R. (2006). Age-related eye disease, visual impairment, and survival: the Beaver Dam Eye Study. Arch Ophthalmol. 124. 243-249
  • Swenson, CJ, Trepka, MJ, Rewers, MJ, Scarbro, S, Hiatt, WR, Hamman, RF. (2002). Cardiovascular disease mortality in Hispanics and non-Hispanic whites. Am J Epidemiol. 156. 919-928
  • Gimeno Orna, JA, Boned Juliani, B, Lou Arnal, LM, Castro Alonso, FJ. (2002). Mortalidad en una cohorte de pacientes con diabetes tipo 2 del área de Alcañiz, España. An Med Interna. 19. 336-340
  • Zoega, GM, Gunnarsdottir, T, Bjornsdottir, S, Hreietharsson, AB, Viggosson, G, Stefansson, E. (2005). Screening compliance and visual outcome in diabetes. Acta Ophthalmol Scand. 83. 687-690
  • Esteban Ortega, MM, Rodríguez Hurtado, F, Jiménez Moleón, JJ, Bueno Cavanillas, A. (1999). Prevalencia de la retinopatía en diabéticos de más de diez años de evolución en la zona Norte de Granada. Arch Soc Esp Oftalmol. 74. 137-144
  • González, F, López, MI, Gómez-Ulla, F. (2006). Retinopatía Diabética: Tratado médico quirúrgico. MacLine. Madrid.
  • Arana, R. (2004). El coste de no prevenir. Infodiab. 25. 1
  • Javitt, JC, Aiello, LP. (1996). Cost-effectiveness of detecting and treating diabetic retinopathy. Ann Inter Med. 124. 164-169