Zhao Di, Guallar Eliseo, Gajwani Prateek, Swenor Bonnielin, Crews John, Saaddine Jinan, Mudie Lucy, Varadaraj Varshini, Friedman David S
Dana Center for Preventive Ophthalmology, The Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland; Departments of Epidemiology and Medicine, and Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland.
Dana Center for Preventive Ophthalmology, The Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Am J Ophthalmol. 2017 Aug;180:18-28. doi: 10.1016/j.ajo.2017.05.017. Epub 2017 May 24.
To develop, implement, and evaluate a replicable community-based screening intervention designed to improve glaucoma and other eye disease detection and follow-up care in high-risk populations in the United States. We present the design of the study and describe the findings of the first year of the program.
Prospective study to evaluate screening and follow-up.
This is an ongoing study to develop an eye screening program using trained personnel to identify individuals with ophthalmic needs, focusing on African Americans ≥50 years of age at multiple inner-city community sites in Baltimore, Maryland. The screening examination uses a sequential referral approach and assesses presenting visual acuity (VA), best-corrected VA, digital fundus imaging, visual field testing, and measurement of intraocular pressure.
We screened 901 individuals between January 2015 and October 2015. Subjects were mostly African Americans (94.9%) with a mean (standard deviation) age of 64.3 (9.9) years. Among them, 356 (39.5%) participants were referred for a definitive eye examination and 107 (11.9%) only needed prescription glasses. The most common reasons for referral were ungradable fundus image (39.3% of those referred), best-corrected VA < 20/40 (14.6%), and ungradable autorefraction (11.8%). Among people referred for definitive examination, 153 (43%) people attended their scheduled examination. The most common diagnoses at the definitive examination were glaucoma and cataract (51% and 40%, respectively).
A large proportion of individuals screened required ophthalmic services, particularly those who were older and less well educated. To reach and encourage these individuals to attend screenings and follow-up examinations, programs could develop innovative strategies and approaches.
开发、实施并评估一项可复制的基于社区的筛查干预措施，旨在改善美国高危人群青光眼及其他眼部疾病的检测和后续护理。我们展示了该研究的设计，并描述了该项目第一年的研究结果。
评估筛查及随访的前瞻性研究。
这是一项正在进行的研究，旨在利用经过培训的人员开发一项眼部筛查项目，以识别有眼科需求的个体，重点关注马里兰州巴尔的摩多个市中心社区地点年龄≥50岁的非裔美国人。筛查检查采用序贯转诊方法，评估当前视力（VA）、最佳矫正视力、数字眼底成像、视野测试和眼压测量。
2015年1月至2015年10月期间，我们对901人进行了筛查。受试者大多为非裔美国人（94.9%），平均（标准差）年龄为64.3（9.9）岁。其中，356名（39.5%）参与者被转诊进行确定性眼科检查，107名（11.9%）仅需要配镜。转诊的最常见原因是眼底图像不可分级（占转诊者的39.3%）、最佳矫正视力<20/40（14.6%）和自动验光不可分级（11.8%）。在被转诊进行确定性检查的人群中，153人（43%）参加了他们的预定检查。确定性检查中最常见的诊断是青光眼和白内障（分别为51%和40%）。
很大一部分接受筛查的个体需要眼科服务，尤其是那些年龄较大且受教育程度较低的人。为了接触并鼓励这些个体参加筛查和后续检查，项目可以制定创新的策略和方法。
