[Fundus screening by medical technicians].
Ocular fundus photography allows detection of both ocular and systemic diseases. This study investigated the efficacy of a broad screening in a department of internal medicine using nonmydriatic digital fundus photography. For 8 weeks a medical technician was trained in using the camera as well as interpreting the photographs. The medical technician and an ophthalmologist evaluated the fundus photographs separately by using a self-developed questionnaire. The fundus camera was user-friendly and after several weeks of adjustment and practical application the medical technician was able to detect the majority of pathological fundus photographs. Out of 218 patients examined 148 (68%) were identified as pathological by the medical technician and 163 (75%) by the ophthalmologist (p = 0.0003). The medical technician missed 15 (7%) patients. Furthermore the diagnoses made by the medical technician were faulty. In summary an ophthalmological screening by a medical technician is feasible but the diagnosis still remains the responsibility of ophthalmologists. Such a compromise could facilitate the examination of a large number of patients and disclose previously unrecognized diseases.
Augenklinik, Universität Heidelberg, INF 400, 69120, Heidelberg, Deutschland. florian.schuett@med.uni-heidelberg.de
F
F
Schütt
T
T
Bruckner
K
K
Schäfer
D
D
Lehnhoff
G
G
Rudofsky
C
C
Kasperk
P
P
Nawroth
G U
GU
Auffarth
D005260:Female; D005451:Fluorescein Angiography / Q000706:statistics & numerical data*; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D009881:Ophthalmic Assistants / Q000706:statistics & numerical data*; D010820:Physicians / Q000706:statistics & numerical data*; D015995:Prevalence; D011361:Professional Competence; D015203:Reproducibility of Results; D012164:Retinal Diseases / Q000175:diagnosis* / Q000453:epidemiology*; D012680:Sensitivity and Specificity