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B Patton, CM Tafur, IJ Suner; Digital Imaging Technology for Effective Screening of Diabetic Retinopathy in Low-Risk Patients . Invest. Ophthalmol. Vis. Sci. 2002;43(13):551.
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Purpose: Diabetic retinopathy is a leading preventable cause of visual loss. There have been recommendations to decrease the frequency of screening for diabetic retinopathy to every two years in patients with hemoglobin A1C (HbA1C) less than 7%. A validated digital imaging fundus screening technique using a commercially-available system was used to examine the prevalence of diabetic retinopathy in a Veterans Affairs Medical Center population without known retinopathy in high-risk (HbA1C≥7%) and low-risk (HbA1C<7%) patients. Methods: Patients presenting the Miami Veterans Affairs Medical Center Eye Clinic for diabetic screening exams without known diabetic retinopathy were examined in a prospective fashion using aa Topcon TR-50X digital imaging system with a protocol to capture areas comprising the Airlie-House photographic criteria. Diabetic retinopathy was defined as the presence of visible microaneurysms, dot hemorrhages, exudates, venous beading, peripheral hemorrhages, intraretinal microvascular abnormalities, vitreous hemorrhage, or proliferative retinopathy. Results: 222 consecutive patients without known diabetic retinopathy were examined over a period of six months. 37.9% of patients with HbA1C ≥7% had diabetic retinopathy, while 19.4% of low-risk patients had diabetic retinopathy. Conclusion: All diabetic patients, regardless of HbA1C levels, should receive annual screening exams for retinopathy. Digital imaging provides an efficient, patient-friendly strategy for screening patients without known diabetic retinopathy.
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