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Titolo:
How do general practitioners diagnose and manage patients with transient monocular loss of vision of sudden onset?
Autore:
Donders, RCJM; Kappelle, LJ; Algra, A; van Dik, GW; van Gijn, J;
Indirizzi:
Univ Utrecht, Med Ctr, Dept Neurol, NL-3584 CX Utrecht, Netherlands Univ Utrecht Utrecht Netherlands NL-3584 CX 3584 CX Utrecht, Netherlands Univ Utrecht, Med Ctr, Julius Ctr Patient Oritented Res, NL-3584 CX Utrecht, Netherlands Univ Utrecht Utrecht Netherlands NL-3584 CX 3584 CX Utrecht, Netherlands
Titolo Testata:
JOURNAL OF NEUROLOGY
fascicolo: 12, volume: 246, anno: 1999,
pagine: 1145 - 1150
SICI:
0340-5354(199912)246:12<1145:HDGPDA>2.0.ZU;2-O
Fonte:
ISI
Lingua:
ENG
Soggetto:
ISCHEMIC ATTACKS;
Keywords:
transient monocular blindness; general practitioner; diagnosis; management;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Life Sciences
Citazioni:
9
Recensione:
Indirizzi per estratti:
Indirizzo: Donders, RCJM Univ Utrecht, Med Ctr, Dept Neurol, Heidelberglaan 100, NL-3584 CX Utrecht, Netherlands Univ Utrecht Heidelberglaan 100 Utrecht Netherlands NL-3584 CX
Citazione:
R.C.J.M. Donders et al., "How do general practitioners diagnose and manage patients with transient monocular loss of vision of sudden onset?", J NEUROL, 246(12), 1999, pp. 1145-1150

Abstract

Symptoms of transient loss of vision in one eye differ widely. They may have different causes and therefore carry a different prognosis. We studied the influence of differences between characteristics of transient monocular blindness on the diagnosis and management by general practitioners (GPs). Apostal questionnaire, was sent to 1600 GPs in The Netherlands along with four case vignettes describing a case history of a 56-year-old man with transient monocular disturbances of vision of sudden onset. We introduced random permutations in the following four elements of the history: partial or complete visual field involved, blurring or blacking out of vision, attacks lasting minutes or hours, and patients having covered either eye during the attack or not. Respondents were asked about the probable diagnosis and the preferred management. For each of the 16 permutations about 50 responses were obtained (overall response rate 54%). Ischemic transient monocular blindness (ITMB) was chosen as the most likely diagnosis in 49%. In 12% primary ocular disease was suspected. Involvement of the complete visual field, blacking out of vision, and short attacks were identified as independent predictors of a diagnosis of ITMB. A diagnosis of ITMB would have resulted in referral to a specialist in 72% of patients. Antithrombotic treatment would have been initiated in only 36% of ITMB patients. GPs consider brief attackswith complete blacking out of vision most typical for retinal ischemia. They refer only three-quarters of patients with probable ITMB to a specialistand start antithrombotic medication in only one-third of these patients. Therefore further education with regard to transient monocular blindness is needed.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 10/07/20 alle ore 19:06:08