Rasmussen Marie L R, Cehofski Lasse J, Davies Julie, Faber Carsten, Falk Mads K, Grauslund Jakob, Hansen Michael S, Keane Pearse A, Natarajan Sundaram, Peto Tunde, Subhi Yousif, Wykoff Charles C, Muttuvelu Danson V
Department of Ophthalmology, Rigshospitalet, Glostrup, Denmark.
Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
Ophthalmol Ther. 2024 Sep;13(9):2467-2480. doi: 10.1007/s40123-024-01008-8. Epub 2024 Aug 2.
This study reports our experiences with systematic retinal screening in Denmark through optometrists with access to tele-ophthalmological services before, during, and after the COVID-19 pandemic.
We evaluated an optometrist-based retinal screening system with a referral option for tele-ophthalmological service by a consultant ophthalmologist within the time period of August 1, 2018 to September 30, 2023. The optometrist collected patient history, refraction, best-corrected visual acuity, intraocular pressure, basic slit-lamp examination, 4-in-1 visual field report, and retinal imaging using color fundus 45° photography. Tele-ophthalmological services were provided by consultant ophthalmologists. Within pre-defined periods of pre-COVID-19, COVID-19, and post-COVID-19, we evaluated the rate of referrals to the tele-ophthalmological service, diagnoses made, and referrals to the public healthcare system.
A total of 1,142,028 unique individuals, which corresponded to 19.1% of the entire population of Denmark, underwent screening by the optometrists; 50,612 (4.4%) of these individuals were referred to the tele-ophthalmological examination by consultant ophthalmologists. A referral for further ophthalmic examination, either at hospital or at an ophthalmic practice, was made for 10,300 individuals (20.4% of those referred for tele-ophthalmology, corresponding to 0.9% of the population screened). The referral rate from the screening to the tele-ophthalmological service increased from before COVID-19 (3.4%) to during COVID-19 (4.3%) and further after COVID-19 (6.4%). This increase coincided with an increasing prevalence of conditions seen in the tele-ophthalmological service.
During a period of 5 years, 19.1% of the entire population of Denmark underwent retinal screening. This provided an adjunctive health service during a period of severe strain on the public healthcare system, while limiting the number of excessive referrals to the public healthcare system. Temporal trends illustrated an increased pattern of use of a large-scale tele-ophthalmological system.
本研究报告了我们在丹麦通过验光师进行系统性视网膜筛查的经验，这些验光师在2019年冠状病毒病大流行之前、期间和之后均可使用远程眼科服务。
我们评估了一个基于验光师的视网膜筛查系统，该系统在2018年8月1日至2023年9月30日期间可由眼科顾问医生提供远程眼科服务转诊选项。验光师收集患者病史、验光、最佳矫正视力、眼压、基本裂隙灯检查、四联视野报告以及使用彩色眼底45°摄影进行视网膜成像。远程眼科服务由眼科顾问医生提供。在2019年冠状病毒病大流行前、期间和之后的预定义时间段内，我们评估了转诊至远程眼科服务的比例、做出的诊断以及转诊至公共医疗系统的情况。
共有1,142,028名不同个体接受了验光师的筛查，占丹麦总人口的19.1%；其中50,612人（4.4%）被眼科顾问医生转诊进行远程眼科检查。10,300人（占远程眼科转诊人数的20.4%，相当于筛查人群的0.9%）被转诊至医院或眼科诊所进行进一步眼科检查。从筛查到远程眼科服务的转诊率从2019年冠状病毒病大流行前的3.4%增加到流行期间的4.3%，在大流行后进一步增至6.4%。这一增长与远程眼科服务中所见病症患病率的增加相吻合。
在5年期间，丹麦19.1%的总人口接受了视网膜筛查。这在公共医疗系统面临严重压力的时期提供了一项辅助性医疗服务，同时限制了转至公共医疗系统的过度转诊数量。时间趋势表明大规模远程眼科系统的使用呈增加模式。
