Gomel Nir, Azem Nur, Baruch Tzidkiyahu, Hollander Nadine, Rachmiel Rony, Kurtz Shimon, Waisbourd Michael
Division of Ophthalmology, Tel-Aviv Medical Center, Tel Aviv, Israel.
Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Telemed J E Health. 2022 Feb;28(2):233-239. doi: 10.1089/tmj.2021.0098. Epub 2021 May 17.
The purpose of this study was to investigate the feasibility and effectiveness of an innovative telemedicine community-based intervention to increase detection of previously undiagnosed ocular diseases in high-risk populations in Israel. A team comprising an ocular technician, a project manager, and a driver was sent to underserved areas in Israel. Patient demographics, ocular, and medical information were recorded. Visual acuity (VA), intraocular pressure and fundus photographs were obtained. The data were transferred to the Ophthalmology Reading Center in Tel-Aviv Medical Center, where it was interpreted by an ophthalmologist. A letter was sent to the patients indicating examination results. It instructed them to return for a follow-up examination if indicated. A total of 124 individuals underwent telemedicine remote screening examinations in 10 locations. The mean age was 79.9 ± 7.2 years, with female predominance of 67%. The major pathologies detected were (1) reduction in VA >6/12 in at least one eye ( = 48, 38.7%); (2) glaucoma suspicion in the optic disk ( = 18, 14.5%); (3) ocular hypertension >21 mmHg ( = 15, 12.1%); (4) age-related macular degeneration (AMD; = 15, 12.1%); (5) diabetic retinopathy ( = 6, 4.8%); (6) visually significant cataract ( = 6, 4.8%); and (7) other pathologies ( = 11, 8.9%); 97.7% of the patients reported high satisfaction rates (they were satisfied or very satisfied from the project model). Our pilot telemedicine screening project effectively detected ocular diseases in underserved areas in Israel and helped improve access to eye care. This project has the potential of reaching a national level, allow for early diagnosis, and prevent vision loss and blindness in underserved areas.
本研究的目的是调查一种创新的基于社区的远程医疗干预措施在以色列高危人群中增加对先前未诊断眼部疾病检测的可行性和有效性。一个由眼科技术员、项目经理和司机组成的团队被派往以色列服务不足的地区。记录了患者的人口统计学、眼部和医疗信息。获取了视力(VA)、眼压和眼底照片。数据被传输到特拉维夫医疗中心的眼科阅读中心,由眼科医生进行解读。向患者发送了一封信,告知检查结果。信中指示他们在有需要时回来进行后续检查。共有124人在10个地点接受了远程医疗远程筛查检查。平均年龄为79.9±7.2岁,女性占主导,比例为67%。检测到的主要病症包括:(1)至少一只眼睛的视力下降>6/12(n = 48,38.7%);(2)视盘青光眼可疑(n = 18,14.5%);(3)眼压>21 mmHg(n = 15,12.1%);(4)年龄相关性黄斑变性(AMD;n = 15,12.1%);(5)糖尿病视网膜病变(n = 6,4.8%);(6)具有视觉意义的白内障(n = 6,4.8%);以及(7)其他病症(n = 11,8.9%);97.7%的患者报告满意度很高(他们对项目模式感到满意或非常满意)。我们的试点远程医疗筛查项目有效地在以色列服务不足的地区检测到了眼部疾病,并有助于改善获得眼科护理的机会。该项目有潜力推广到全国范围,实现早期诊断,并预防服务不足地区的视力丧失和失明。