BY QUINN PHILLIPS | NOVEMBER 10, 2022
Family doctors may be effective at identifying diabetic retinopathy despite not being eye specialists, according to the results of a new study designed to test their ability to do so. The study was presented at 2022 meeting of the American Academy of Ophthalmology, and described in an article at Healio.
Diabetic retinopathy is an eye disease that can develop due to elevated blood glucose levels over time, potentially leading to vision loss. It’s a widespread complication of diabetes, and cases are only expected to rise in the future. But even though vision impairment may be on the rise in people with diabetes, it’s not inevitable — with timely screening and treatment, diabetic retinopathy can be managed and most vision loss can be prevented. Of course, it’s best to prevent retinopathy in the first place through good blood glucose control and lifestyle factors, which may include steps as simple as drinking coffee.
Family doctors highly accurate at identifying diabetic retinopathy
For the latest study, researchers asked five family medicine doctors and one retina specialist to evaluate images — taken with a specialized camera called a fundus camera — of the eyes of 2,260 people with diabetes over the course of a year. Among all of these images, the five family doctors correctly identified 27 cases of moderate to severe nonproliferative diabetic retinopathy (NPDR), which were also identified by the retina specialist. No cases of proliferative diabetic retinopathy — the more severe form — were found by either the family doctors or the retina specialist. When it came to images identified as not showing diabetic retinopathy, there was 99.7% agreement between the family doctors and the retina specialist — the family doctors indicated that 2,039 images showed no evidence of retinopathy, compared with 2,032 images that the retina specialist judged as normal.
Out of 180 images that the family doctors referred for further assessment because they wanted a second opinion, they correctly identified 42 as most likely not showing retinopathy retinopathy, while 51 were deemed to be “doubtful cases” of retinopathy and 83 were deemed as unreadable by the family doctors. The family doctors also identified four false-positive cases of retinopathy — meaning they believed the images showed the condition, while the retina specialist determined they did not.
Overall, this study showed that the family doctors were “excellent” at identifying which images of their patients’ eyes show evidence of retinopathy, which ones do not, and which ones require further evaluation, according to the researchers. Giving primary care doctors — including family doctors — more responsibility in this area could allow more people with diabetes to get screened for retinopathy, potentially leading to more people getting the treatment they need.
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