Nguyen Pamela L, Amezcua Moreno Jose, Tran Diep, McHugh Kathleen, Woreta Fasika A, Collins Megan E, Cai Cindy X
Wilmer Eye Institute, Johns Hopkins School of Medicine, Baltimore, MD, USA.
Shepherd's Clinic, Baltimore, MD, USA.
Clin Ophthalmol. 2024 Nov 11;18:3227-3236. doi: 10.2147/OPTH.S483004. eCollection 2024.
To characterize the baseline characteristics and clinical outcomes of patients seen through the Free Diabetic Screening (FDS) program, a free diabetic retinopathy screening program for uninsured patients, in the ophthalmology resident clinic at the Wilmer Eye Institute.
This retrospective longitudinal cohort study included uninsured patients ≥18 years with diabetes mellitus seen through the FDS clinic from 2013 to 2023. Data extraction was performed using manual chart review of the first FDS visit, and automated extraction of the data warehouse related to all other office visits. Patient demographic and clinical characteristics at presentation, treatments, and follow-ups were collected.
A total of 422 patients were included in this study (mean age 52 years; 59% female; 47% Hispanic; 49% Spanish as primary language). One-third of patients had some form of diabetic retinopathy or diabetic macular edema, and 12% had vision-threatening diabetic retinopathy at presentation. In all, nearly 10% of patients were referred for further specialty care, and 71% of these patients completed at least one follow-up visit. The majority of patients (55%) returned for care as recommended and were followed for a mean length of 200 weeks and 10 office visits.
The FDS clinic provided much needed diabetic retinopathy screening and treatment for uninsured patients in Baltimore City and surrounding areas. This study highlights the need for strong integration between initial screening and downstream services, as nearly 10% of patients require further sub-specialty intervention or care.
描述通过免费糖尿病筛查（FDS）项目就诊的患者的基线特征和临床结局。FDS项目是威尔默眼科研究所眼科住院医师诊所为未参保患者提供的免费糖尿病视网膜病变筛查项目。
这项回顾性纵向队列研究纳入了2013年至2023年期间通过FDS诊所就诊的年龄≥18岁的未参保糖尿病患者。通过人工查阅首次FDS就诊病历进行数据提取，并自动提取与所有其他门诊就诊相关的数据仓库信息。收集患者就诊时的人口统计学和临床特征、治疗情况及随访情况。
本研究共纳入422例患者（平均年龄52岁；59%为女性；47%为西班牙裔；49%以西班牙语为主要语言）。三分之一的患者患有某种形式的糖尿病视网膜病变或糖尿病性黄斑水肿，就诊时12%的患者患有威胁视力的糖尿病视网膜病变。总体而言，近10%的患者被转诊接受进一步的专科治疗，其中71%的患者至少完成了一次随访就诊。大多数患者（55%）按建议复诊，平均随访时长为200周，门诊就诊10次。
FDS诊所为巴尔的摩市及周边地区的未参保患者提供了急需的糖尿病视网膜病变筛查和治疗。本研究强调了初始筛查与下游服务紧密整合的必要性，因为近10%的患者需要进一步的亚专科干预或治疗。
