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Tytuł pozycji:

Retinal exams requested at Primary Care Unit: indications, results and alternative strategies of evaluation

Tytuł :
Retinal exams requested at Primary Care Unit: indications, results and alternative strategies of evaluation
Autorzy :
Malerbi, Fernando Korn
Carneiro, Adriano Biondi Monteiro
Katz, Marcelo
Lottenberg, Claudio Luiz
Pokaż więcej
Temat :
Centros de Saúde
Telemedicine
genetic structures
Telemedicina
Glaucoma
Retinopatia diabética
sense organs
Primary Health Care
Medicine
Atenção Primária à Saúde
Gestão E Economia EM Saúde
Diabetic retinopathy
Análise custo-eficiência
Health Centers
Cost efficiency analysis
eye diseases
Health Economics and Management
Źródło :
Einstein (São Paulo), Vol 18
Wydawca :
Instituto Israelita de Ensino e Pesquisa Albert Einstein, 2019.
Rok publikacji :
2019
Kolekcja :
DOAJ-Articles_enriched
Datacite
Datacite_enriched
DOAJ-Articles
Oryginalny identyfikator :
pmc: PMC6905169
pmid: 31531556
Język :
English
ISSN :
2317-6385
DOI :
10.31744/einstein_journal/2020gs4913
Objective To evaluate indications, results and strategy of retinal exams requested at Primary Care Units. Methods A retrospective study that analyzed the indications and results of retinal exams, in the modalities clinical dilated fundus exams and color fundus photographs. In the following situations, patients were considered eligible for color fundus photographs if visual acuity was normal and ocular symptoms were absent: diabetes mellitus and/or hypertension, in use of drugs with potential retinal toxicity, diagnosis or suspicion of glaucoma, stable and asymptomatic retinopathies, except myopia greater than -3.00 diopters. Results A total of 1,729 patients were evaluated (66% female, age 63.5±15.5 years), and 1,190 underwent clinical dilated fundus exam and 539 underwent color fundus photographs. Diabetes was present in 32.2%. The main indications were diabetes (23.7%) and glaucoma evaluation (23.5%). In 3.4% of patients there was no apparent indication. The main results were a large cup/disc ratio (30.7%) and diabetic retinopathy (13.2%). Exam was normal in 9.6%, detected peripheral changes in 7% and could not be performed in 1%. Considering patients eligible for fundus photographs (22.4%), more than half underwent clinical dilated fundus exams. Conclusion Regarding exam modality, there were no important differences in the distribution of indications or diagnosis. Color fundus photograph is compatible with telemedicine and more cost-effective, and could be considered the strategy of choice in some scenarios. Since there are no clear guidelines for retinal exams indications or the modality of choice, this study may contribute to such standardization, in order to optimize public health resources.

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