Abstract：
BACKGROUND: Patients in rural Australia have limited access to intravitreal treatments due to a maldistribution of the ophthalmology workforce. To improve access, a novel outreach service model was implemented whereby junior medical staff administered intravitreal injections under a supervising ophthalmology consultant. This model involves outreach visits in hospitals, mobile clinics and a remote hub with intravitreal injections administered by junior doctors overseen by an ophthalmologist. The article explores the safety of this approach with respect to the rate of post-injection endophthalmitis.
METHODS: A retrospective audit was conducted by the Lions Outback Vision outreach ophthalmology service from 2017 to mid-2023. The number of injections, locations, diagnoses, intravitreal agents used, designation of administering doctor and cases of endophthalmitis were reviewed.
RESULTS: A 12 632 intravitreal injections were administered across 32 locations throughout rural Western Australia in the 6.5-year period. Three cases of endophthalmitis occurred representing a rate of 0.0237%.
CONCLUSIONS: The rate of endophthalmitis in the outreach service is comparable to other centres. The outreach model with supervising ophthalmology consultant support in person or via telehealth and administration of injections by junior medical staff has improved access for underserved or marginalised populations.
METHODS: A retrospective audit was conducted by the Lions Outback Vision outreach ophthalmology service from 2017 to mid-2023. The number of injections, locations, diagnoses, intravitreal agents used, designation of administering doctor and cases of endophthalmitis were reviewed.
RESULTS: A 12 632 intravitreal injections were administered across 32 locations throughout rural Western Australia in the 6.5-year period. Three cases of endophthalmitis occurred representing a rate of 0.0237%.
CONCLUSIONS: The rate of endophthalmitis in the outreach service is comparable to other centres. The outreach model with supervising ophthalmology consultant support in person or via telehealth and administration of injections by junior medical staff has improved access for underserved or marginalised populations.
摘要：
背景：由于眼科劳动力分布不均，澳大利亚农村地区的患者获得玻璃体内治疗的机会有限。为了改善访问，实施了一种新的外展服务模式,即初级医务人员在眼科顾问的监督下进行玻璃体内注射.这种模式涉及医院的外展访问，流动诊所和一个远程中心，由初级医生在眼科医生的监督下进行玻璃体内注射。本文探讨了这种方法在注射后眼内炎发生率方面的安全性。
方法：2017年至2023年中期，LionsOutbackVision外展眼科服务进行了回顾性审核。注射次数,地点,诊断,使用的玻璃体内药物，对给药医生的指定和眼内炎的病例进行了回顾。
结果：在6.5年期间，在整个西澳大利亚农村的32个地点进行了12632次玻璃体内注射。3例发生眼内炎，发生率为0.0237％。
结论：外展服务中的眼内炎发生率与其他中心相当。通过亲自监督眼科顾问支持或通过远程医疗和初级医务人员注射管理的外展模式改善了服务不足或边缘化人群的获取。
方法：2017年至2023年中期，LionsOutbackVision外展眼科服务进行了回顾性审核。注射次数,地点,诊断,使用的玻璃体内药物，对给药医生的指定和眼内炎的病例进行了回顾。
结果：在6.5年期间，在整个西澳大利亚农村的32个地点进行了12632次玻璃体内注射。3例发生眼内炎，发生率为0.0237％。
结论：外展服务中的眼内炎发生率与其他中心相当。通过亲自监督眼科顾问支持或通过远程医疗和初级医务人员注射管理的外展模式改善了服务不足或边缘化人群的获取。
