Interpretation of <i>National consensus on the management of major chronic fundus diseases in China: a modified Delphi approach</i>_Chinese Journal of Ocular Fundus Diseases

Authors：

Liu Kun , Chen Chong ,  Xu Xun

Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Eye Diseases, Shanghai 200080, China;

Corresponding?author：

Xu Xun, Email: drxuxun@sjtu.edu.cn

Keywords：

Chronic Fundus disease management; Pathways for clinical diagnosis and treatment; Interpretation of expert consensus

DOI：

10.3760/cma.j.cn511434-20240328-00126

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Based on the current situation of patients with retinal diseases in China and the clear requirements of the "14th Five-Year Plan for Eye Health (2021-2025)" to strengthen the construction of the prevention and control system for retinal diseases, experts in the field of retinal diseases in China have conducted in-depth and comprehensive thematic discussions, and used the modified Delphi method for collective decision-making and opinion solicitation, ultimately forming consensus and consistent guidance suggestions for the management of chronic diseases of retinal diseases that are in line with China's national conditions. This consensus includes key content such as definitions, treatment plans, and follow-up frequency for the management of chronic diseases of the fundus. It clearly proposes relevant measures to improve the management process of chronic diseases of the fundus, and elaborates on the advantages and feasibility of establishing an online remote platform for the management of chronic diseases of the fundus, in order to assist doctors in formulating personalized treatment plans and ensure that patients receive standardized treatment and follow-up. This consensus will provide guidance and reference for the management of chronic diseases and long-term standardized diagnosis and treatment of major fundus diseases in China.

Citation： Liu Kun, Chen Chong, Xu Xun. Interpretation of National consensus on the management of major chronic fundus diseases in China: a modified Delphi approach. Chinese Journal of Ocular Fundus Diseases, 2024, 40(5): 342-346. doi: 10.3760/cma.j.cn511434-20240328-00126 Copy

1.	國家衛生健康委. “十四五”全國眼健康規劃(2021-2025年)[EB/OL]. [2022-01-04]. http://www.nhc.gov.cn/yzygj/s7653/202201/d607d24b6b1c4bd9b827eedf41eff820.shtml.National Health Commission. 14th Five-Year Plan for Eye Health(2021-2025)[EB/OL]. [2022-01-04]. http://www.nhc.gov.cn/yzygj/s7653/202201/d607d24b6b1c4bd9b827eedf41eff820.shtml.
2.	Zhou C, Li S, Ye L, et al. Visual impairment and blindness caused by retinal diseases: a nationwide register-based study[J/OL]. J Glob Health, 2023, 13: 4126[2023-11-03]. https://pubmed.ncbi.nlm.nih.gov/37921040/. DOI: 10.7189/jogh.13.04126.
3.	Song P, Du Y, Chan KY, et al. The national and subnational prevalence and burden of age-related macular degeneration in China[J/OL]. J Glob Health, 2017, 7(2): 20703[2017-12-02]. https://pubmed.ncbi.nlm.nih.gov/29302323/. DOI: 10.7189/jogh.07.020703.
4.	Wong WL, Su X, Li X, et al. Global prevalence of age-related macular degeneration and disease burden projection for 2020 and 2040: a systematic review and meta-analysis[J/OL]. Lancet Glob Health, 2014, 2(2): e106-e116[2014-01-03]. https://pubmed.ncbi.nlm.nih.gov/25104651/. DOI: 10.1016/S2214-109X(13)70145-1.
5.	Ye H, Zhang Q, Liu X, et al. Prevalence of age-related macular degeneration in an elderly urban chinese population in China: the Jiangning Eye Study[J]. Invest Ophthalmol Vis Sci, 2014, 55(10): 6374-6380. DOI: 10.1167/iovs.14-14899.
6.	Teo ZL, Tham YC, Yu M, et al. Global prevalence of diabetic retinopathy and projection of burden through 2045: systematic review and meta-analysis[J]. Ophthalmology, 2021, 128(11): 1580-1591. DOI: 10.1016/j.ophtha.2021.04.027.
7.	Yau JW, Rogers SL, Kawasaki R, et al. Global prevalence and major risk factors of diabetic retinopathy[J]. Diabetes Care, 2012, 35(3): 556-564. DOI: 10.2337/dc11-1909.
8.	Holden BA, Fricke TR, Wilson DA, et al. Global prevalence of myopia and high myopia and temporal trends from 2000 through 2050[J]. Ophthalmology, 2016, 123(5): 1036-1042. DOI: 10.1016/j.ophtha.2016.01.006.
9.	Baird PN, Saw SM, Lanca C, et al. Myopia[J]. Nat Rev Dis Primers, 2020, 6(1): 99. DOI: 10.1038/s41572-020-00231-4.
10.	Scott IU, Campochiaro PA, Newman NJ, et al. Retinal vascular occlusions[J]. Lancet, 2020, 396(10266): 1927-1940. DOI: 10.1016/S0140-6736(20)31559-2.
11.	Lau JT, Lee V, Fan D, et al. Knowledge about cataract, glaucoma, and age related macular degeneration in the Hong Kong Chinese population[J]. Br J Ophthalmol, 2002, 86(10): 1080-1084. DOI: 10.1136/bjo.86.10.1080.
12.	Zhang CX, Zhang GM, Ma N, et al Awareness of age-related macular degeneration and its risk factors among Beijing residents in China[J]. Chin Med J (Engl), 2017, 130(2): 155-159. DOI: 10.4103/0366-6999.197994.
13.	周芬, 謝紅莉, 瞿佳. 眼科資源現狀及服務能力調查[J]. 中國醫院, 2008, 12(4): 14-16. DOI: 10.3969/j.issn.1671-0592.2008.04.006.Zhou F, Xie HL, Qu J. Investigation on ophthalmology resource and service skill[J]. Chinese Hospitals, 2008, 12(4): 14-16. DOI: 10.3969/j.issn.1671-0592.2008.04.006.
14.	Polack S, Yorston D, López-Ramos A, et al. Rapid assessment of avoidable blindness and diabetic retinopathy in Chiapas, Mexico[J]. Ophthalmology, 2012, 119(5): 1033-1040. DOI: 10.1016/j.ophtha.2011.11.002.
15.	鄒海東, 張晳, 許迅, 等. 上海市靜安區曹家渡街道年齡相關性黃斑變性的患病率調查[J]. 中華眼科雜志, 2005, 41(1): 15-19. DOI: 10.3760/j:issn:0412-4081.2005.01.005.Zou HD, Zhang X, Xu X, et al. Prevalence study of age-related macular degeneration in Caojiadu blocks, Shanghai[J]. Chin J Ophthalmol, 2005, 41(1): 15-19. DOI: 10.3760/j:issn:0412-4081.2005.01.005.
16.	Gonder JR, Walker VM, Barbeau M, et al. Costs and quality of life in diabetic macular edema: Canadian burden of diabetic macular edema observational study (C-REALITY)[J/OL]. J Ophthalmol, 2014, 2014: 939315[2014-03-26]. https://pubmed.ncbi.nlm.nih.gov/24795818/. DOI: 10.1155/2014/939315.
17.	單侯乾, 潘蓓, 左麗倩, 等. 蘭州市糖尿病視網膜病變患者住院費用分析[J]. 中國初級衛生保健, 2019, 33(7): 51-54. DOI: 10.3969/j.issn.1001-568X.2019.07.0017.Shan HQ, Pan B, Zuo LQ, et al. Analysis on the hospitalization expenses of patients with diabetic retinopathy in Lanzhou[J]. Chinese Primary Health Care, 2019, 33(7): 51-54. DOI: 10.3969/j.issn.1001-568X.2019.07.0017.
18.	Rees G, Xie J, Fenwick EK, et al. Association between diabetes-related eye complications and symptoms of anxiety and depression[J]. JAMA Ophthalmol, 2016, 134(9): 1007-1014. DOI: 10.1001/jamaophthalmol.2016.2213.
19.	陳有信. 對年齡相關性黃斑變性的公眾認知度亟待提高[J]. 中華眼科雜志, 2009, 45(5): 389-392. DOI: 10.3760/cma.j.issn.0412-4081.2009.05.002.Chen YX. Urgent action needed to raise public awareness of age-related macular degeneration in China[J]. Chin J Ophthalmol, 2009, 45(5): 389-392. DOI: 10.3760/cma.j.issn.0412-4081.2009.05.002.
20.	Meads C, Hyde C. What is the cost of blindness?[J]. Br J Ophthalmol, 2003, 87(10): 1201-1204. DOI: 10.1136/bjo.87.10.1201.
21.	Holz FG, Minnella AM, Tuli R, et al. Ranibizumab treatment patterns in prior ranibizumab-treated neovascular age-related macular degeneration patients: real-world outcomes from the LUMINOUS study[J/OL]. PLoS One, 2020, 15(12): e0244183[2020-12-30]. https://pubmed.ncbi.nlm.nih.gov/33378369/. DOI: 10.1371/journal.pone.0244183.
22.	中華醫學會眼科學分會眼底病學組, 中國醫師協會眼科醫師分會眼底病學組. 我國主要眼底病慢病管理專家共識——基于改良版德爾菲法制訂[J]. 中華眼底病雜志, 2024, 40(4): 253-263. DOI: 10.3760/cma.j.cn511434-20240220-00076.Fundus Fundus Disease Group of Ophthalmological Society of Chinese Medical Association, Fundus Disease Group of Ophthalmologist Branch of Chinese Medical Doctor Association. National consensus on the management of major chronic fundus diseases in China: a modified Delphi approach[J]. Chin J Ocul Fundus Dis, 2024, 40(4): 253-263. DOI: 10.3760/cma.j.cn511434-20240220-00076.
23.	García Layana A, Adán A, Ascaso FJ, et al. Use of intravitreal dexamethasone implants in the treatment of diabetic macular edema: expert recommendations using a Delphi approach[J]. Eur J Ophthalmol, 2020, 30(5): 1042-1052. DOI: 10.1177/1120672119861623.
24.	Kodjikian L, Baillif S, Couturier A, et al. Recommendations for the management of diabetic macular oedema with intravitreal dexamethasone implant: a national Delphi consensus study[J]. Eur J Ophthalmol, 2022, 32(5): 2845-2856. DOI: 10.1177/112067 21211052852.
25.	?zen S, Sag E, Ben-Chetrit E, et al. Defining colchicine resistance/intolerance in patients with familial Mediterranean fever: a modified-Delphi consensus approach[J]. Rheumatology (Oxford), 2021, 60(8): 3799-3808. DOI: 10.1093/rheumatology/keaa863.
26.	陶洋旭, 李建軍. 醫療共識制訂方法: 德爾菲法和名義小組法[J]. 國際眼科縱覽, 2021, 45(5): 369-373. DOI: 10.3760/cma.j.issn.1673-5803.2021.05.001.Tao YX, Li JJ. Delphi method and nominal group method for medical consensus formation[J]. Int Rev Ophthalmol, 2021, 45(5): 369-373. DOI: 10.3760/cma.j.issn.1673-5803.2021.05.001.
27.	中華醫學會眼科學分會眼底病學組, 中國醫師協會眼科醫師分會眼底病學組. 中國年齡相關性黃斑變性臨床診療指南(2023年)[J]. 中華眼科雜志, 2023, 59(5): 347-366. DOI: 10.3760/cma.j.cn112142-20221222-00649.Chinese Vitreo-Retina Society of Chinese Medical Association, Fundus Disease Group of Chinese Ophthalmologist Association. Evidence-based guidelines for diagnosis and treatment of age-related macular degeneration in China (2023)[J]. Chin J Ophthalmol, 2023, 59(5): 347-366. DOI: 10.3760/cma.j.cn112142-20221222-00649.
28.	中華醫學會眼科學分會眼底病學組, 中國醫師協會眼科醫師分會眼底病學組. 我國糖尿病視網膜病變臨床診療指南(2022年)[J]. 中華眼底病雜志, 2023, 39(2): 99-124. DOI: 10.3760/cma.j.cn511434-20230110-00018.Fundus Disease Group of Ophthalmological Society of Chinese Medical Association, Fundus Disease Group of Ophthalmologist Branch of Chinese Medical Doctor Association. Evidence-based guidelines for diagnosis and treatment of diabetic retinopathy in China (2022)[J]. Chin J Ocul Fundus Dis, 2023, 39(2): 99-124. DOI: 10.3760/cma.j.cn511434-20230110-00018.
29.	苗恒, 黎曉新, 趙明威. 《中國視網膜靜脈阻塞臨床診療路徑專家共識》解讀[J]. 中華眼底病雜志, 2024, 40(3): 186-189. DOI: 10.3760/cma.j.cn511434-20240218-00071.Miao H, Li XX, Zhao MW. Interpretation of Expert consensus on clinical diagnosis and treatment path of retinal vein occlusion in China[J]. Chin J Ocul Fundus Dis, 2024, 40(3): 186-189. DOI: 10.3760/cma.j.cn511434-20240218-00071.

1. 國家衛生健康委. “十四五”全國眼健康規劃(2021-2025年)[EB/OL]. [2022-01-04]. http://www.nhc.gov.cn/yzygj/s7653/202201/d607d24b6b1c4bd9b827eedf41eff820.shtml.National Health Commission. 14th Five-Year Plan for Eye Health(2021-2025)[EB/OL]. [2022-01-04]. http://www.nhc.gov.cn/yzygj/s7653/202201/d607d24b6b1c4bd9b827eedf41eff820.shtml.
2. Zhou C, Li S, Ye L, et al. Visual impairment and blindness caused by retinal diseases: a nationwide register-based study[J/OL]. J Glob Health, 2023, 13: 4126[2023-11-03]. https://pubmed.ncbi.nlm.nih.gov/37921040/. DOI: 10.7189/jogh.13.04126.
3. Song P, Du Y, Chan KY, et al. The national and subnational prevalence and burden of age-related macular degeneration in China[J/OL]. J Glob Health, 2017, 7(2): 20703[2017-12-02]. https://pubmed.ncbi.nlm.nih.gov/29302323/. DOI: 10.7189/jogh.07.020703.
4. Wong WL, Su X, Li X, et al. Global prevalence of age-related macular degeneration and disease burden projection for 2020 and 2040: a systematic review and meta-analysis[J/OL]. Lancet Glob Health, 2014, 2(2): e106-e116[2014-01-03]. https://pubmed.ncbi.nlm.nih.gov/25104651/. DOI: 10.1016/S2214-109X(13)70145-1.
5. Ye H, Zhang Q, Liu X, et al. Prevalence of age-related macular degeneration in an elderly urban chinese population in China: the Jiangning Eye Study[J]. Invest Ophthalmol Vis Sci, 2014, 55(10): 6374-6380. DOI: 10.1167/iovs.14-14899.
6. Teo ZL, Tham YC, Yu M, et al. Global prevalence of diabetic retinopathy and projection of burden through 2045: systematic review and meta-analysis[J]. Ophthalmology, 2021, 128(11): 1580-1591. DOI: 10.1016/j.ophtha.2021.04.027.
7. Yau JW, Rogers SL, Kawasaki R, et al. Global prevalence and major risk factors of diabetic retinopathy[J]. Diabetes Care, 2012, 35(3): 556-564. DOI: 10.2337/dc11-1909.
8. Holden BA, Fricke TR, Wilson DA, et al. Global prevalence of myopia and high myopia and temporal trends from 2000 through 2050[J]. Ophthalmology, 2016, 123(5): 1036-1042. DOI: 10.1016/j.ophtha.2016.01.006.
9. Baird PN, Saw SM, Lanca C, et al. Myopia[J]. Nat Rev Dis Primers, 2020, 6(1): 99. DOI: 10.1038/s41572-020-00231-4.
10. Scott IU, Campochiaro PA, Newman NJ, et al. Retinal vascular occlusions[J]. Lancet, 2020, 396(10266): 1927-1940. DOI: 10.1016/S0140-6736(20)31559-2.
11. Lau JT, Lee V, Fan D, et al. Knowledge about cataract, glaucoma, and age related macular degeneration in the Hong Kong Chinese population[J]. Br J Ophthalmol, 2002, 86(10): 1080-1084. DOI: 10.1136/bjo.86.10.1080.
12. Zhang CX, Zhang GM, Ma N, et al Awareness of age-related macular degeneration and its risk factors among Beijing residents in China[J]. Chin Med J (Engl), 2017, 130(2): 155-159. DOI: 10.4103/0366-6999.197994.
13. 周芬, 謝紅莉, 瞿佳. 眼科資源現狀及服務能力調查[J]. 中國醫院, 2008, 12(4): 14-16. DOI: 10.3969/j.issn.1671-0592.2008.04.006.Zhou F, Xie HL, Qu J. Investigation on ophthalmology resource and service skill[J]. Chinese Hospitals, 2008, 12(4): 14-16. DOI: 10.3969/j.issn.1671-0592.2008.04.006.
14. Polack S, Yorston D, López-Ramos A, et al. Rapid assessment of avoidable blindness and diabetic retinopathy in Chiapas, Mexico[J]. Ophthalmology, 2012, 119(5): 1033-1040. DOI: 10.1016/j.ophtha.2011.11.002.
15. 鄒海東, 張晳, 許迅, 等. 上海市靜安區曹家渡街道年齡相關性黃斑變性的患病率調查[J]. 中華眼科雜志, 2005, 41(1): 15-19. DOI: 10.3760/j:issn:0412-4081.2005.01.005.Zou HD, Zhang X, Xu X, et al. Prevalence study of age-related macular degeneration in Caojiadu blocks, Shanghai[J]. Chin J Ophthalmol, 2005, 41(1): 15-19. DOI: 10.3760/j:issn:0412-4081.2005.01.005.
16. Gonder JR, Walker VM, Barbeau M, et al. Costs and quality of life in diabetic macular edema: Canadian burden of diabetic macular edema observational study (C-REALITY)[J/OL]. J Ophthalmol, 2014, 2014: 939315[2014-03-26]. https://pubmed.ncbi.nlm.nih.gov/24795818/. DOI: 10.1155/2014/939315.
17. 單侯乾, 潘蓓, 左麗倩, 等. 蘭州市糖尿病視網膜病變患者住院費用分析[J]. 中國初級衛生保健, 2019, 33(7): 51-54. DOI: 10.3969/j.issn.1001-568X.2019.07.0017.Shan HQ, Pan B, Zuo LQ, et al. Analysis on the hospitalization expenses of patients with diabetic retinopathy in Lanzhou[J]. Chinese Primary Health Care, 2019, 33(7): 51-54. DOI: 10.3969/j.issn.1001-568X.2019.07.0017.
18. Rees G, Xie J, Fenwick EK, et al. Association between diabetes-related eye complications and symptoms of anxiety and depression[J]. JAMA Ophthalmol, 2016, 134(9): 1007-1014. DOI: 10.1001/jamaophthalmol.2016.2213.
19. 陳有信. 對年齡相關性黃斑變性的公眾認知度亟待提高[J]. 中華眼科雜志, 2009, 45(5): 389-392. DOI: 10.3760/cma.j.issn.0412-4081.2009.05.002.Chen YX. Urgent action needed to raise public awareness of age-related macular degeneration in China[J]. Chin J Ophthalmol, 2009, 45(5): 389-392. DOI: 10.3760/cma.j.issn.0412-4081.2009.05.002.
20. Meads C, Hyde C. What is the cost of blindness?[J]. Br J Ophthalmol, 2003, 87(10): 1201-1204. DOI: 10.1136/bjo.87.10.1201.
21. Holz FG, Minnella AM, Tuli R, et al. Ranibizumab treatment patterns in prior ranibizumab-treated neovascular age-related macular degeneration patients: real-world outcomes from the LUMINOUS study[J/OL]. PLoS One, 2020, 15(12): e0244183[2020-12-30]. https://pubmed.ncbi.nlm.nih.gov/33378369/. DOI: 10.1371/journal.pone.0244183.
22. 中華醫學會眼科學分會眼底病學組, 中國醫師協會眼科醫師分會眼底病學組. 我國主要眼底病慢病管理專家共識——基于改良版德爾菲法制訂[J]. 中華眼底病雜志, 2024, 40(4): 253-263. DOI: 10.3760/cma.j.cn511434-20240220-00076.Fundus Fundus Disease Group of Ophthalmological Society of Chinese Medical Association, Fundus Disease Group of Ophthalmologist Branch of Chinese Medical Doctor Association. National consensus on the management of major chronic fundus diseases in China: a modified Delphi approach[J]. Chin J Ocul Fundus Dis, 2024, 40(4): 253-263. DOI: 10.3760/cma.j.cn511434-20240220-00076.
23. García Layana A, Adán A, Ascaso FJ, et al. Use of intravitreal dexamethasone implants in the treatment of diabetic macular edema: expert recommendations using a Delphi approach[J]. Eur J Ophthalmol, 2020, 30(5): 1042-1052. DOI: 10.1177/1120672119861623.
24. Kodjikian L, Baillif S, Couturier A, et al. Recommendations for the management of diabetic macular oedema with intravitreal dexamethasone implant: a national Delphi consensus study[J]. Eur J Ophthalmol, 2022, 32(5): 2845-2856. DOI: 10.1177/112067 21211052852.
25. ?zen S, Sag E, Ben-Chetrit E, et al. Defining colchicine resistance/intolerance in patients with familial Mediterranean fever: a modified-Delphi consensus approach[J]. Rheumatology (Oxford), 2021, 60(8): 3799-3808. DOI: 10.1093/rheumatology/keaa863.
26. 陶洋旭, 李建軍. 醫療共識制訂方法: 德爾菲法和名義小組法[J]. 國際眼科縱覽, 2021, 45(5): 369-373. DOI: 10.3760/cma.j.issn.1673-5803.2021.05.001.Tao YX, Li JJ. Delphi method and nominal group method for medical consensus formation[J]. Int Rev Ophthalmol, 2021, 45(5): 369-373. DOI: 10.3760/cma.j.issn.1673-5803.2021.05.001.
27. 中華醫學會眼科學分會眼底病學組, 中國醫師協會眼科醫師分會眼底病學組. 中國年齡相關性黃斑變性臨床診療指南(2023年)[J]. 中華眼科雜志, 2023, 59(5): 347-366. DOI: 10.3760/cma.j.cn112142-20221222-00649.Chinese Vitreo-Retina Society of Chinese Medical Association, Fundus Disease Group of Chinese Ophthalmologist Association. Evidence-based guidelines for diagnosis and treatment of age-related macular degeneration in China (2023)[J]. Chin J Ophthalmol, 2023, 59(5): 347-366. DOI: 10.3760/cma.j.cn112142-20221222-00649.
28. 中華醫學會眼科學分會眼底病學組, 中國醫師協會眼科醫師分會眼底病學組. 我國糖尿病視網膜病變臨床診療指南(2022年)[J]. 中華眼底病雜志, 2023, 39(2): 99-124. DOI: 10.3760/cma.j.cn511434-20230110-00018.Fundus Disease Group of Ophthalmological Society of Chinese Medical Association, Fundus Disease Group of Ophthalmologist Branch of Chinese Medical Doctor Association. Evidence-based guidelines for diagnosis and treatment of diabetic retinopathy in China (2022)[J]. Chin J Ocul Fundus Dis, 2023, 39(2): 99-124. DOI: 10.3760/cma.j.cn511434-20230110-00018.
29. 苗恒, 黎曉新, 趙明威. 《中國視網膜靜脈阻塞臨床診療路徑專家共識》解讀[J]. 中華眼底病雜志, 2024, 40(3): 186-189. DOI: 10.3760/cma.j.cn511434-20240218-00071.Miao H, Li XX, Zhao MW. Interpretation of Expert consensus on clinical diagnosis and treatment path of retinal vein occlusion in China[J]. Chin J Ocul Fundus Dis, 2024, 40(3): 186-189. DOI: 10.3760/cma.j.cn511434-20240218-00071.

Previous Article
Expert consensus on diagnosis and treatment of choroideremia (2024)
Next Article
Longitudinal natural history study of visual acuity in choroideremia

Chinese Journal of Ocular Fundus Diseases

Interpretation of National consensus on the management of major chronic fundus diseases in China: a modified Delphi approach

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content