A Potential Pathway for Managing Diabetic Patients with Arterial Emboli Detected by Retinal Screening

Abstract Objective The aim was to review a pathway of care for diabetic patients found to have retinal artery emboli detected by retinal screening. Design This was a retrospective review of a pathway agreed in 2001 by a multidisciplinary team. Materials and methods The prospectively collected Glouce...

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Bibliographic Details
Published in:European journal of vascular and endovascular surgery 2011-08, Vol.42 (2), p.153-157
Main Authors: Hadley, G, Earnshaw, J.J, Stratton, I, Sykes, J, Scanlon, P.H
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Angioplasty
Asymptomatic carotid disease
Asymptomatic Diseases
Carotid endarterectomy
Carotid Stenosis - diagnostic imaging
Carotid Stenosis - epidemiology
Carotid Stenosis - surgery
Critical Pathways
Diabetes
Diabetic Retinopathy - diagnosis
Diabetic Retinopathy - epidemiology
Endarterectomy, Carotid
England - epidemiology
Female
Fluorescein Angiography
Humans
Interdisciplinary Communication
Male
Mass Screening - methods
Middle Aged
Patient Care Team
Predictive Value of Tests
Prevalence
Retinal Artery Occlusion - diagnosis
Retinal Artery Occlusion - epidemiology
Retinal embolism
Retrospective Studies
Screening
Severity of Illness Index
Surgery
Treatment Outcome
Ultrasonography, Doppler, Duplex
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Summary:Abstract Objective The aim was to review a pathway of care for diabetic patients found to have retinal artery emboli detected by retinal screening. Design This was a retrospective review of a pathway agreed in 2001 by a multidisciplinary team. Materials and methods The prospectively collected Gloucestershire Diabetic Retinal Screening Programme database was reviewed; patients sent for carotid duplex imaging underwent review of their scan results and their casenotes. Results The prevalence of retinal emboli was 214 out of 25,299 diabetic patients who had retinal screening (0.85%). Some 200 diabetic patients underwent carotid duplex imaging; 23 had ipsilateral and 2 had contralateral carotid stenosis >70%. Of these, ten patients underwent carotid endarterectomy without any major morbidity. Conculsions A pathway was established for the small number of patients with retinal emboli, and could be tested in other populations.
ISSN:1078-5884
1532-2165
DOI:10.1016/j.ejvs.2011.04.031