{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T01:59:01Z","timestamp":1782179941568,"version":"3.54.5"},"reference-count":17,"publisher":"Georg Thieme Verlag KG","issue":"04","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Exp Clin Endocrinol Diabetes"],"published-print":{"date-parts":[[2023,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Background Retinal screening is mandatory to prevent vision loss and\n                    blindness due to diabetic retinopathy (DR). The aim of the study was to\n                    determine retinopathy screening rates and potential barriers in a German\n                    metropolitan diabetes care center.<\/jats:p><jats:p>\n          Methods Between May and October 2019, 265 patients with diabetes mellitus\n                    (95% type 2 diabetes; age 62\u00b113.2 years; diabetes duration\n                    11.1\u00b18.5 years, HbA1c 7.4\u00b11.0%) were referred to an\n                    ophthalmologist (referral form with order \u201cFundoscopy in diabetes\n                    mellitus, findings requested,\u201d completed documentation form\n                    \u201cGeneral practitioner\u2019s\/diabetologist\u2019s report\n                    to the ophthalmologist\u201d and prepared documentation form\n                    \u201cOphthalmologist\u2019s report\u201d). A structured interview was\n                    used to assess the level of compliance with the guidelines and to identify\n                    potential barriers to retinopathy screening in a real-world setting, including\n                    the quantification of extra payments.<\/jats:p><jats:p>\n          Results All patients were interviewed at 7.9\u00b12.5 months after the\n                    referral for retinopathy screening had been issued. According to patient\n                    reporting, fundoscopy was performed in 191 (75%) patients.\n                    Ophthalmological reports were obtained from 119\/191 (62%)\n                    patients (46% of the entire cohort). 10\/119 (8%)\n                    patients had been previously diagnosed with DR and 6\/119 (5%)\n                    with new-onset DR. In 158\/191 (83%) of patients, the referral\n                    had been accepted by the ophthalmology practice, of which 25,1% made a\n                    co-payment of 36.2\u00b137.6 \u20ac.<\/jats:p><jats:p>\n          Discussion Despite a high screening performance in a real-world setting,\n                    complete screening in compliance with German guidelines, including written\n                    reporting, was found in less than half of the cohort. The prevalence and\n                    incidence of DR are high. Even when referred according to the regulations,\n                    one-quarter of patients made a co-payment. Efficient solutions to current\n                    barriers can emerge with mutual time-saving information prior to examination and\n                    feedback about the implementation of findings into treatment.<\/jats:p>","DOI":"10.1055\/a-2002-5116","type":"journal-article","created":{"date-parts":[[2023,4,13]],"date-time":"2023-04-13T22:33:45Z","timestamp":1681425225000},"page":"182-186","source":"Crossref","is-referenced-by-count":4,"title":["Screening Results for Diabetic Retinopathy in Germany in a Real-world\n                    Cohort in a Metropolitan Diabetes Care Center"],"prefix":"10.1055","volume":"131","author":[{"given":"Bernardo","family":"Mertes","sequence":"additional","affiliation":[{"name":"Centre for Cardioangiology Bethanien, AGAPLESION Hospital Bethanien,\n                    Department for Diabetology"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nadine","family":"Kuniss","sequence":"additional","affiliation":[{"name":"Jena University Hospital, Department of Internal Medicine\n                    III"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Piorkowski","sequence":"additional","affiliation":[{"name":"Centre for Cardioangiology Bethanien, AGAPLESION Hospital Bethanien,\n                    Department for Diabetology"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linus Paul","family":"Mertes","sequence":"additional","affiliation":[{"name":"Centre for Cardioangiology Bethanien, AGAPLESION Hospital Bethanien,\n                    Department for Diabetology"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hans-Peter","family":"Hammes","sequence":"additional","affiliation":[{"name":"Universita\u0308tsmedizin Mannheim, University of Heidelberg, 5th\n                    Medical Department"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2023,4,13]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"156","DOI":"10.1016\/j.preteyeres.2015.08.001","article-title":"The progress in understanding and treatment of diabetic retinopathy","volume":"51","author":"A W Stitt","year":"2016","journal-title":"Prog Retin Eye Res"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"29","DOI":"10.1007\/s00125-017-4435-8","article-title":"Diabetic retinopathy: Hyperglycaemia, oxidative stress and beyond","volume":"61","author":"H P Hammes","year":"2018","journal-title":"Diabetologia"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"170","DOI":"10.1016\/j.diabres.2018.07.004","article-title":"Global perspectives on the provision of diabetic retinopathy screening and\n                    treatment: Survey of health care professionals in 41 countries","volume":"143","author":"D Cavan","year":"2018","journal-title":"Diabetes Res Clin Pract"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"164","DOI":"10.7326\/0003-4819-124-1_part_2-199601011-00017","article-title":"Cost-effectiveness of detecting and treating diabetic retinopathy","volume":"124","author":"J C Javitt","year":"1996","journal-title":"Ann Intern Med"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"337","DOI":"10.1016\/S2213-8587(19)30411-5","article-title":"Screening for diabetic retinopathy: New perspectives and challenges","volume":"8","author":"S Vujosevic","year":"2020","journal-title":"Lancet Diabetes Endocrinol"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"1","DOI":"10.3310\/hta19740","article-title":"Development of a cost-effectiveness model for optimisation of the screening\n                    interval in diabetic retinopathy screening","volume":"19","author":"P H Scanlon","year":"2015","journal-title":"Health Technol 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Diabetol"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"16","DOI":"10.1016\/j.diabres.2017.03.023","article-title":"The Diabetic Retinopathy Barometer Study: Global perspectives on access to and\n                    experiences of diabetic retinopathy screening and treatment","volume":"129","author":"D Cavan","year":"2017","journal-title":"Diabetes Res Clin Pract"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"556","DOI":"10.2337\/dc11-1909","article-title":"Global prevalence and major risk factors of diabetic retinopathy","volume":"35","author":"J W Yau","year":"2012","journal-title":"Diabetes Care"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"1913","DOI":"10.1007\/s00125-016-4013-5","article-title":"Prevalence of diabetic retinopathy in screening-detected diabetes mellitus:\n                    Results from the Gutenberg Health Study (GHS","volume":"59","author":"K A Ponto","year":"2016","journal-title":"Diabetologia"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"570","DOI":"10.1055\/s-0043-120570","article-title":"Prevalence and progression rate of diabetic retinopathy in type 2 diabetes\n                    patients in correlation with the duration of diabetes","volume":"126","author":"M Voigt","year":"2018","journal-title":"Exp Clin Endocrinol Diabetes"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"255","DOI":"10.1093\/eurheartj\/ehz486","article-title":"2019 ESC Guidelines on diabetes, pre-diabetes, and cardiovascular diseases\n                    developed in collaboration with the EASD","volume":"41","author":"F Cosentino","year":"2020","journal-title":"Eur Heart J"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"1238","DOI":"10.2337\/dc11-0079","article-title":"Diabetic retinopathy predicts all-cause mortality and cardiovascular events in\n                    both type 1 and 2 diabetes: Meta-analysis 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UK\n                    Prospective Diabetes Study Group","volume":"42","author":"E M Kohner","year":"1999","journal-title":"Diabetologia"}],"container-title":["Experimental and Clinical Endocrinology &amp; Diabetes"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2002-5116.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,4,13]],"date-time":"2023-04-13T22:33:47Z","timestamp":1681425227000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2002-5116"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,4]]},"references-count":17,"journal-issue":{"issue":"04","published-online":{"date-parts":[[2023,4,13]]},"published-print":{"date-parts":[[2023,4]]}},"URL":"https:\/\/doi.org\/10.1055\/a-2002-5116","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0947-7349","1439-3646"],"issn-type":[{"value":"0947-7349","type":"print"},{"value":"1439-3646","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,4]]}}}