Journal Information
Vol. 7. Issue 36.
Pages 123-130 (May - June 1993)
Vol. 7. Issue 36.
Pages 123-130 (May - June 1993)
Open Access
Tardanza en el Tratamiento de la Retlnopatía Diabética: Efectividad de un Tratamiento Eficaz*
“Lateness” in Treating Diabetic Retinopathy: Effectiveness of an Efficacious Treatment
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Itziar Larizgoitia**, José F. Veintemillas
Johns Hopkings University. School of Hygiene & Public Health. Department of Health Policy & Management
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Resumen

A pesar de la eficacia de la fotocoagulación por laser como tratamiento para la Retinopatía Diabética (RD), en la practica, ésta se demuestra no efectiva en la medida en que esta condición es la primera causa de ceguera en nuestro medio. En el presente estudio se ha intentado valorar si dicha pérdida de efectividad se debe a un defecto en los mecanismos de detección precoz de la RD. Para ello se ha estudiado el comportamiento preventivo de una muestra de diabéticos seleccionada en dos hospitales del sector público de Vizcaya, y se ha definido el indicador Tardanza como medida de la pérdida de efectividad del tratamiento, debido a defectos en la cadena preventivo-asistencial de RD. Un 75% de los casos estudiados no seguía un método de detección precoz adecuado y la mitad de los casos accedía tarde al tratamiento. Entre los diabéticos insulino-dependientes, los de mayor edad y mayor duración de la diabetes son los que presentan mayor riesgo de acceder tarde. Entre los no insulino-depen-dientes no observamos ningún tipo de asociación. Se puede concluir que la mayoría de diabéticos no recibe una atención preventiva adecuada para evitar la ceguera por RD, y que, cuando acceden al servicio especializado, presentan un estadio de RD demasiado avanzado para beneficiarse al máximo del tratamiento.

Palabras clave:
Retinopatía diabética
Prevención
Fotocoagulación
Efectividad
Summary

Despite the efficacy of lasar photocoagulation as the treatment for Diabetic Retinopathy, this condition is the leading cause of blindness in developed countries. In this survey we have tried to find out whether this lack of effectiveness is due to a lack of adequate control and screening. As a proxy measure for this we have developed an indicator called “Lateness” and we have followed a sample of diabetics drawn from the two public hospitals in Vizcaya (Spain). Seventy five percent of them were not at regular intervals and half of the sample was late for treatment. Among these, Insulin dependent diabetics of older age and with more years of the disease are at a higher of entering late for treatment. We could not find any riskfactor lateness among non insulin dependent diabetics. We concluded that most of diabetics are not adequately followed up for the prevention of diabetic retinopalhy, and when they are referred to treatment it is too take the most advantage of it.

Key words:
Diabetic retinopathy
Prevention
Photocoagulation
Effectiveness
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Bibliografía
[1.]
A. Sorsby.
The incidence and causes of blindness in England and Wales 1963–1965.
HMSO, (1972),
[2.]
Early Treatment Diabetic Retinopathy Study group.
Photocoagulation for Diabetic Macular Edema.
Arch Opthalmol, 103 (1985), pp. 1796-1806
[3.]
Diabetic Research Study group.
Photocoagulation treatment of Proliferative Diabetic Rettinopathy. The second report of DRS findings.
Ophthalmology, 85 (1978), pp. 583-600
[4.]
W.H. Herman, S.M. Teutsch, S.J. Sepe, P. Sinnock, R. Klein.
An approach to the prevention of blindness in diabetes.
Diabetes Care, 6 (1983), pp. 608-612
[5.]
American College of Physicians.
American Diabetes Association, American Academy of Ophthalmology Screening Guidelines for Diabetic Retinopathy.
Ann Intern Med, 116 (1992), pp. 683-685
[6.]
Royal College of Physicians of London (Committee on Endrocrinology and Diabetes Mellitus) and British Diabetic Association.
The provision of Medical care for Adult Diabetic Patients in the United Kingdom.
¿, (1984),
[7.]
National Diabetes Advisory Board.
The prevention and Tretament of five complications of Diabetes: A guide for Primary Care practitioners.
Diabetes Care, 6 (1983), pp. XXXIV-XXXVI
[8.]
G.D. Rogell.
Diabetic Eye Care 1986: Education is key.
MD Med J, 35 (1986), pp. 585-586
[9.]
R. Ohri, E. Kohner.
Screning for Diabetic Retinopathy.
Practical Diabetes, 3 (1986), pp. 214-215
[10.]
E.A. Savolainen, Q.P. Lee.
Diabetic Retinopathy-Need and demand for photocoagulation and its cost effectiveness. Evaluation based on services in the U.K.
Diabetología, 23 (1982), pp. 138-140
[11.]
T. Barrie.
Current options in management: proliferative diabetic eye disease.
Trans Opthalmol Soc UK, 103 (1983), pp. 125-132
[12.]
Burns-Cox, J.C. Dean Hart.
Screening for Retinopathy by Opthalmic.
BMJ, 290 (1985), pp. 1052-1054
[13.]
W.S. Foulds, A. McCuish, T. Barrie, F. Green, I.N. Scobie, I.M. Ghafour, et al.
Diabetic Retinopathy in the West of Scotland: Its detection and Prevalence and the cost-effectiveness of a proposed screening programme.
Health Bull, 41/6 (1983), pp. 318-326
[14.]
E.J. Sussman, W.G. Tsiaras, K.A. Soper.
Diagnosis of Diabetes Eye Disease.
JAMA, 247 (1982), pp. 3231-3234
[15.]
D.G. Kleinbaum, L.L. Kupper, H. Morgenstern.
Epidemiologic Research. Principles and quantitative methods.
Van Nostrand Reinhold Company, (1982),
[16.]
V. Abraira, J. Zaplana.
PRESTA V2.0. Paquete de Procesamientos Estadísticos.
Fondo de Investigaciones Sanitarias de la Seguridad Social, (1989),
[17.]
S.R. Witkin, R. Klein.
Ophthalmologic care for persons with diabetes.
JAMA, 251 (1984), pp. 2534-2537
[18.]
J.S. Yudkin, B.J. Boucher, K.E. Schopflin, B.T. Harris, H.R. Claff, N.J.D. Whyte, et al.
The quality of Diabetic Care in a London Health district.
J Epidemiol Community Health, 34 (1980), pp. 277-280
[19.]
R. Jones, I. Larizgoitia, L. Casado, T. Barrie.
How effective is the referral cahin for retinopathy?.
Diabetic Medicine, 6 (1989), pp. 262-266
[20.]
Y. Pouliquen.
Oftalmología.
Masson Barcelona, (1986),
[21.]
R. Klein, B.E. Klein, S. Moss, M. Davis, D.L. deMets.
The Wisconsin Epidemiologic Study of Diabetic Retinopathy. II Prevalence and Risk of Diabetic Retinopathy when age at diagnosis is less than 30 years.
Arch Opthalmol, 102 (1984), pp. 520-526
[22.]
R. Klein, B.E. Klein, S. Moss, M. Davis, D.L. de Mets.
The Wisconsin Epidemiologic Study od Diabetic Retinopathy. Ill Prevalence and Risk of Diabetic Retinopathy when age at diagnosis is 30 years or more.
Arch Opthalmol, 102 (1984), pp. 527-532
[23.]
J. Ballard.
Risk factors for Diabetic Retinopathy.
Diabetes Care, 9 (1986), pp. 334-342
[24.]
N.W. Knuiman, T.A. Welborn, V.J. McCann, K.G. Stanton, I.J. Constable.
Prevalence of Diabetic complications in relations to risk factors.
Diabetes, 35 (1986), pp. 1332-1339
[25.]
E. Wilkes, E.E. Lawton.
The diabetic, the hospital and primary care.
J R Coll Gen Pract, 30 (1980), pp. 199-206
[26.]
B.J. Doney.
An audit of the care of diabetics in a group practice.
J R Coll Gen Pract, 26 (1976), pp. 734-742

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Copyright © 1993. Sociedad Española de Salud Pública y Administración Sanitaria
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