背景:这项研究报告了我们在丹麦通过验光师进行系统视网膜筛查的经验,during,在COVID-19大流行之后。
方法:在2018年8月1日至2023年9月30日期间,我们评估了基于验光师的视网膜筛查系统,并由眼科医生顾问提供远程眼科服务的转诊选择。验光师收集了病史,折射,最佳矫正视力,眼内压,基本裂隙灯检查,4合1视野报告,使用彩色眼底45°摄影和视网膜成像。眼科顾问提供远程眼科服务。在COVID-19之前、COVID-19和COVID-19之后的预定时间段内,我们评估了远程眼科服务的转诊率,诊断,和转介给公共医疗系统。
结果:共有1,142,028个独特个体,相当于丹麦总人口的19.1%,接受了验光师的筛查;这些人中有50,612人(4.4%)接受了顾问眼科医生的远程眼科检查。进一步眼科检查的转诊,无论是在医院还是在眼科诊所,是为10,300名个体(占远程眼科转诊者的20.4%,相当于接受筛查的人群的0.9%)。从筛查到远程眼科服务的转诊率从COVID-19之前(3.4%)增加到COVID-19期间(4.3%),再到COVID-19之后(6.4%)。这种增加与远程眼科服务中出现的疾病患病率增加相吻合。
结论:在5年内,丹麦总人口的19.1%接受了视网膜筛查。在公共医疗系统严重紧张的时期,这提供了辅助医疗服务,同时限制过度转诊给公共医疗系统的数量。时间趋势表明,大规模远程眼科系统的使用模式有所增加。
BACKGROUND: This study reports our experiences with systematic retinal screening in Denmark through optometrists with access to tele-ophthalmological services before, during, and after the COVID-19 pandemic.
METHODS: We evaluated an optometrist-based retinal screening system with a referral option for tele-ophthalmological service by a consultant ophthalmologist within the time period of August 1, 2018 to September 30, 2023. The optometrist collected patient history, refraction, best-corrected visual acuity, intraocular pressure, basic slit-lamp examination, 4-in-1 visual field report, and retinal imaging using color fundus 45° photography. Tele-ophthalmological services were provided by consultant ophthalmologists. Within pre-defined periods of pre-COVID-19, COVID-19, and post-COVID-19, we evaluated the rate of referrals to the tele-ophthalmological service, diagnoses made, and referrals to the public healthcare system.
RESULTS: A total of 1,142,028 unique individuals, which corresponded to 19.1% of the entire population of Denmark, underwent screening by the optometrists; 50,612 (4.4%) of these individuals were referred to the tele-ophthalmological examination by consultant ophthalmologists. A referral for further ophthalmic examination, either at hospital or at an ophthalmic practice, was made for 10,300 individuals (20.4% of those referred for tele-ophthalmology, corresponding to 0.9% of the population screened). The referral rate from the screening to the tele-ophthalmological service increased from before COVID-19 (3.4%) to during COVID-19 (4.3%) and further after COVID-19 (6.4%). This increase coincided with an increasing prevalence of conditions seen in the tele-ophthalmological service.
CONCLUSIONS: During a period of 5 years, 19.1% of the entire population of Denmark underwent retinal screening. This provided an adjunctive health service during a period of severe strain on the public healthcare system, while limiting the number of excessive referrals to the public healthcare system. Temporal trends illustrated an increased pattern of use of a large-scale tele-ophthalmological system.