印度验光师进行糖尿病视网膜病变筛查的能力建设：模型描述和试点结果。
Capacity building for diabetic retinopathy screening by optometrists in India: Model description and pilot results.
机构信息
Head, Teleophthalmology, LV Prasad Eye Institute Network Kallam Anji Reddy Campus, L V Prasad Eye Institute, Banjara Hills, Hyderabad, India.
Research Scholar, School of Optometry and Vision Science, The University of New South Wales, UNSW, Sydney, Australia.
出版信息
Indian J Ophthalmol. 2021 Mar;69(3):655-659. doi: 10.4103/ijo.IJO_1944_20.
PURPOSE
The present study's objectives are 1) to describe a novel model of Diabetic Retinopathy Capacity Building (DRCB) for optometrists in the detection of diabetes-related retinal pathology in India and 2) to assess the outcomes of this model by comparing the ability of optometrists to detect these diseases using retinal photographs, vis-à-vis, a specialist ophthalmologist.
METHODS
The DRCB model for optometrists conducted between August 2016 and August 2018 included training, certification in the screening, and referral guidelines for Diabetic Retinopathy (DR) and hospital-and community-based service delivery. Training included a 7-month long fellowship in DR and mentored participation as cofacilitators in 1-day orientation workshops on DR screening guidelines across India. The sensitivity and specificity of study optometrists in screening for DR by fundus photography were compared to a retina specialist before certification.
RESULTS
A total of eight optometrists successfully completed their DR fellowship in the project duration of 24 months. The sensitivity and specificity of detection of any DR were 95 and 79%, any Diabetic macular edema (DME) was 80 and 86%. The sensitivity and specificity of detection of sight threatening DR were 88 and 90% and DME was 72% and 92% respectively. Seven workshops were cofacilitated by study optometrists training 870 optometrists in DR screening guidelines across India.
CONCLUSION
The present DRCB model results advocate for an optometry coordinated DR screening in India. Lessons learnt from this model can be useful in designing community-based task sharing initiatives for optometrists in DR screening.
目的
本研究的目的是 1）描述一种新的专为验光师设计的糖尿病视网膜病变能力建设（DRCB）模式，以提高印度验光师对糖尿病相关视网膜病变的检测能力，2）通过比较验光师使用视网膜照片检测这些疾病的能力与眼科专家的能力，来评估该模式的结果。
方法
2016 年 8 月至 2018 年 8 月期间，为验光师开展的 DRCB 模式包括培训、糖尿病视网膜病变（DR）筛查和转诊指南认证，以及医院和社区服务提供。培训包括为期 7 个月的 DR 进修课程，并在印度各地开展为期 1 天的 DR 筛查指南定向研讨会，以导师身份共同担任协调员。在认证之前，比较研究验光师使用眼底摄影筛查 DR 的敏感性和特异性。
结果
共有 8 名验光师在 24 个月的项目期间成功完成了 DR 进修课程。检测任何 DR 的敏感性和特异性分别为 95%和 79%，任何糖尿病性黄斑水肿（DME）的敏感性和特异性分别为 80%和 86%。检测威胁视力的 DR 的敏感性和特异性分别为 88%和 90%，DME 分别为 72%和 92%。研究验光师共同主持了 7 次研讨会，在印度各地培训了 870 名验光师DR 筛查指南。
结论
本研究中的 DRCB 模式结果提倡在印度开展由验光师协调的 DR 筛查。从该模式中吸取的经验教训可用于设计针对 DR 筛查的社区为基础的任务分担倡议。
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