Glasson Nicola M, Crossland Lisa J, Larkins Sarah L
College of Medicine and Dentistry, James Cook University, 1 James Cook Drive, Townsville City, QLD 4811, Australia.
Discipline of General Practice, University of Queensland, Level 8 Health Sciences Building, Royal Brisbane Hospital, Herston, QLD 4029, Australia.
J Diabetes Res. 2016;2016:1267215. doi: 10.1155/2016/1267215. Epub 2015 Dec 20.
Background. Up to 98% of visual loss secondary to diabetic retinopathy (DR) can be prevented with early detection and treatment. Despite this, less than 50% of Australian and American diabetics receive appropriate screening. Diabetic patients living in rural and remote communities are further disadvantaged by limited access to ophthalmology services. Research Design and Methods. DR screening using a nonmydriatic fundal camera was performed as part of a multidisciplinary diabetes service already visiting remote communities. Images were onforwarded to a distant general practitioner who identified and graded retinopathy, with screen-positive patients referred to ophthalmology. This retrospective, descriptive study aims to compare the proportion of remote diabetic patients receiving appropriate DR screening prior to and following implementation of the service. Results. Of the 141 patients in 11 communities who underwent DR screening, 16.3% had received appropriate DR screening prior to the implementation of the service. In addition, 36.2% of patients had never been screened. Following the introduction of the service, 66.3% of patients underwent appropriate DR screening (p = 0.00025). Conclusion. This innovative model has greatly improved accessibility to DR screening in remote communities, thereby reducing preventable blindness. It provides a holistic, locally appropriate diabetes service and utilises existing infrastructure and health workforce more efficiently.
背景。高达98%的糖尿病视网膜病变（DR）继发视力丧失可通过早期检测和治疗得以预防。尽管如此，澳大利亚和美国不到50%的糖尿病患者接受了适当的筛查。生活在农村和偏远社区的糖尿病患者因获得眼科服务的机会有限而更加处于不利地位。研究设计与方法。作为已经深入偏远社区的多学科糖尿病服务的一部分，使用免散瞳眼底相机进行DR筛查。图像被转发给远方的全科医生，由其识别视网膜病变并进行分级，筛查呈阳性的患者被转诊至眼科。这项回顾性描述性研究旨在比较该服务实施前后接受适当DR筛查的偏远糖尿病患者的比例。结果。在11个社区接受DR筛查的141名患者中，16.3%在该服务实施前接受了适当的DR筛查。此外，36.2%的患者从未接受过筛查。该服务推出后，66.3%的患者接受了适当的DR筛查（p = 0.00025）。结论。这种创新模式极大地提高了偏远社区DR筛查的可及性，从而减少了可预防的失明。它提供了全面、适合当地情况的糖尿病服务，并更有效地利用了现有基础设施和卫生人力。
