Zimmer-Galler Ingrid E, Kimura Alan E, Gupta Sunil
aWilmer Eye Institute, Johns Hopkins University Medical Institutions, Baltimore, Maryland bDepartment of Ophthalmology, University of Colorado Health Sciences Center, Anschutz Medical Campus, Aurora, Colorado, USA cRetina Specialty Institute, Pensacola, FL, USA.
Curr Opin Ophthalmol. 2015 May;26(3):167-72. doi: 10.1097/ICU.0000000000000142.
Evidence-based practice guidelines and treatments are highly effective in reducing vision loss from diabetic retinopathy. However, less than half of the total number of patients with diabetes mellitus receive recommended annual retinal evaluations, and vision loss due to diabetic retinopathy remains the leading cause of blindness in adults. Poor adherence to screening recommendations stems from a number of challenges which telemedicine technology may address to increase the evaluation rates and ultimately reduce vision loss. The aim of this review was to provide an update on the recent advances in tele-ophthalmology and how it may expand our current concept of eye care delivery for diabetic eye disease.
The benefits of telemedicine diabetic retinopathy are proven for large population-based systems. Outcomes information from community-based programs is now also beginning to emerge. Improved screening rates and less vision loss from diabetic retinopathy are being reported after implementation of telemedicine programs. New imaging platforms for telemedicine programs may enhance the ability to detect and grade diabetic retinopathy. However, financial factors remain a barrier to widespread implementation.
Telemedicine diabetic retinopathy screening programs may have a significant impact on reducing the vision complications and healthcare burden from the growing diabetes epidemic.
基于证据的实践指南和治疗方法在减少糖尿病视网膜病变导致的视力丧失方面非常有效。然而，糖尿病患者中接受推荐的年度视网膜评估的人数不到总数的一半，糖尿病视网膜病变导致的视力丧失仍然是成年人失明的主要原因。对筛查建议的依从性差源于一些挑战，远程医疗技术可能有助于解决这些挑战，以提高评估率并最终减少视力丧失。本综述的目的是提供远程眼科的最新进展以及它如何扩展我们目前对糖尿病眼病护理的概念。
远程医疗用于糖尿病视网膜病变的益处已在大型基于人群的系统中得到证实。基于社区项目的结果信息现在也开始出现。实施远程医疗项目后，报告显示糖尿病视网膜病变的筛查率提高，视力丧失减少。用于远程医疗项目的新成像平台可能会增强检测和分级糖尿病视网膜病变的能力。然而，财务因素仍然是广泛实施的障碍。
远程医疗糖尿病视网膜病变筛查项目可能对减少不断增长的糖尿病流行所导致的视力并发症和医疗负担产生重大影响。
