From the Department of Ophthalmology and Visual Sciences (P.A.N-C., L.M.N., A.R.E., A.K.B., O.K., D.J., S.D.W., D.C.M., J.Z., M.A.W.); the Institute for Healthcare Policy and Innovation (P.A.N-C., A.R.E., O.K., D.C.M., M.A.W.), University of Michigan, Ann Arbor.
From the Department of Ophthalmology and Visual Sciences (P.A.N-C., L.M.N., A.R.E., A.K.B., O.K., D.J., S.D.W., D.C.M., J.Z., M.A.W.).
Am J Ophthalmol. 2023 Jul;251:43-51. doi: 10.1016/j.ajo.2023.02.026. Epub 2023 Mar 10.
The Michigan Screening and Intervention for Glaucoma and Eye Health Through Telemedicine (MI-SIGHT) program aims to engage people who are at high risk of glaucoma; we assess first-year outcomes and costs.
Clinical cohort study.
Participants ≥18 years of age were recruited from a free clinic and a federally qualified health center in Michigan. Ophthalmic technicians in the clinics collected demographic information, visual function, ocular health history, measured visual acuity, refraction, intraocular pressure, pachymetry, pupils, and took mydriatic fundus photographs and retinal nerve fiber layer optical coherence tomography. Data were interpreted by remote ophthalmologists. During a follow-up visit, technicians shared ophthalmologist recommendations, dispensed low-cost glasses, and collected participant satisfaction. The primary outcome measures were prevalence of eye disease, visual function, program satisfaction, and costs. Observed prevalence was compared with national disease prevalence rates using z tests of proportions.
Among 1171 participants, the average age was 55 years (SD 14.5 years), 38% were male, 54% identified as Black, 34% as White, 10% as Hispanic, 33% had less than or equal to a high school education, and 70% had an annual income <$30,000. The prevalence of visual impairment was 10.3% (national average 2.2%), glaucoma and suspected glaucoma 24% (national average 9%), macular degeneration 2.0% (national average 1.5%), and diabetic retinopathy 7.3% (national average 3.4%) (P < .0001). Seventy-one percent of participants received low-cost glasses, 41% were referred for ophthalmology follow-up, and 99% were satisfied or very satisfied with the program. Startup costs were $103,185; recurrent costs were $248,103 per clinic.
Telemedicine eye disease detection programs in low-income community clinics effectively identify high rates of pathology.
密歇根州通过远程医疗进行青光眼和眼部健康筛查与干预（MI-SIGHT）计划旨在接触到患有青光眼高危人群；我们评估了第一年的结果和成本。
临床队列研究。
参与者年龄在 18 岁以上，来自密歇根州的一家免费诊所和一家联邦合格的健康中心。诊所的眼科技师收集人口统计学信息、视觉功能、眼部健康史、测量视力、屈光度、眼压、角膜厚度、瞳孔，并进行散瞳眼底照相和视网膜神经纤维层光学相干断层扫描。数据由远程眼科医生进行解释。在随访时，技师会与参与者分享眼科医生的建议，提供低成本眼镜，并收集参与者的满意度。主要结果测量指标是眼病患病率、视觉功能、计划满意度和成本。使用 z 检验比较观察到的患病率与全国疾病患病率。
在 1171 名参与者中，平均年龄为 55 岁（SD 14.5 岁），38%为男性，54%为黑人，34%为白人，10%为西班牙裔，33%受教育程度低于或等于高中，70%的人年收入<30000 美元。视力障碍的患病率为 10.3%（全国平均水平为 2.2%），青光眼和疑似青光眼的患病率为 24%（全国平均水平为 9%），黄斑变性的患病率为 2.0%（全国平均水平为 1.5%），糖尿病视网膜病变的患病率为 7.3%（全国平均水平为 3.4%）（P<0.0001）。71%的参与者获得了低成本眼镜，41%被转诊进行眼科随访，99%对该计划表示满意或非常满意。启动成本为 103185 美元；每个诊所的经常性成本为 248103 美元。
低收入社区诊所的远程医疗眼病检测计划有效地发现了高比例的疾病。
