Appukumran Rohan, Shyamsundar Kripanidhi, Agrawal Mohini, Khurana Rolli, Pannu Anju, Kumar Praveen
Department of Ophthalmology, District Hospital, Palakkad, India.
Department of Ophthalmology, Military Hospital, Roorkee, Uttarakhand, India.
Med Hypothesis Discov Innov Ophthalmol. 2023 Feb 3;11(4):162-170. doi: 10.51329/mehdiophthal1460. eCollection 2022 Winter.
Screening for diabetic retinopathy in the community without compromising the routine work of ophthalmologists at hospitals is the essence of teleophthalmology. This study was aimed at investigating the efficacy of teleophthalmology practice for screening diabetic retinopathy from 2012 to 2020. It was also aimed at comparing the 2-year prevalence of camps organized by a district hospital in South India, as well as the footfall, reporting, follow-up, patient response, and diagnostic efficacy at these camps.
All patients with diabetes and unexplained vision deterioration attending the mobile camp units underwent non-dilated fundus photography. Patients underwent teleconsultation with the ophthalmologist at the district hospital, and those requiring intervention were called to the district hospital. Trends were studied for the number of patients reporting to the hospital. Patient satisfaction was recorded based on a questionnaire.
A total of 682 camps were held over 8 years, and 30 230 patients were examined. Teleconsultation was done for 12 157 (40.21%) patients. Patients requiring further investigations, intervention for diabetic retinopathy, or further management of other ocular pathologies were urgently referred to the district hospital (n= 3293 [10.89%] of 30 230 examined patients). The severity and presence of clinically significant macular edema increased significantly with an increased duration of diabetes mellitus ( < 0.001). The percentage of teleconsultations showed an increasing trend over the years ( = 0.001). Similarly, considering trends of patients reporting to the hospital, the attrition rate decreased over the years ( < 0.05). A total of 10 974 of 12 157 (90.27%) patients who underwent teleophthalmic consultation were satisfied with the service.
Teleconsultations over the years showed an increasing trend, and the attrition rate decreased over the years. Teleophthalmology is achieving success in providing high-quality service, easy access to care, and in increasing patient satisfaction. Future studies on the role of teleophthalmology for other leading preventable causes of blindness seem possible and necessary.
在不影响医院眼科医生日常工作的情况下,在社区进行糖尿病视网膜病变筛查是远程眼科的核心。本研究旨在调查2012年至2020年远程眼科实践筛查糖尿病视网膜病变的效果。同时,旨在比较印度南部一家区级医院组织的义诊活动的两年患病率,以及这些义诊活动的就诊人数、报告情况、随访情况、患者反应和诊断效果。
所有参加流动义诊单位的糖尿病患者和原因不明视力下降患者均接受非散瞳眼底摄影。患者在区级医院与眼科医生进行远程会诊,需要干预的患者被召唤到区级医院。对到医院就诊的患者数量趋势进行了研究。根据问卷记录患者满意度。
8年共举办682场义诊活动,检查30230名患者。对12157名(40.21%)患者进行了远程会诊。需要进一步检查、干预糖尿病视网膜病变或进一步治疗其他眼部疾病的患者被紧急转诊到区级医院(占30230名检查患者中的3293名[10.89%])。随着糖尿病病程的延长,临床显著性黄斑水肿的严重程度和发生率显著增加(<0.001)。多年来远程会诊的比例呈上升趋势(=0.001)。同样,考虑到到医院就诊患者的趋势,多年来流失率有所下降(<0.05)。在12157名接受远程眼科会诊的患者中,共有10974名(90.27%)对服务满意。
多年来远程会诊呈上升趋势,流失率逐年下降。远程眼科在提供高质量服务、方便就医和提高患者满意度方面取得了成功。关于远程眼科在其他主要可预防失明原因中的作用的未来研究似乎是可能且必要的。