Lim Michelle, Felfeli Tina, Mangubat Winnie, Moghimi Hamid, Grinton Michael, Brent Michael H
Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, ON, Canada.
Clin Ophthalmol. 2024 Dec 20;18:3881-3892. doi: 10.2147/OPTH.S491154. eCollection 2024.
To report the results and feasibility of a pilot expansion of the Toronto Tele-Retinal Screening Program in an elderly long-term care home.
Long term care patients with Type II diabetes mellitus (DM) were screened between April 1, 2022, and July 1, 2022. Demographic and health data were collected through surveys.
A total of 28 patients were screened, with 85.7% successfully undergoing retinal imaging. Among imaged patients, 8.3% (2/24) required urgent follow-up. Pathologies identified included uncontrolled glaucoma (4.1%, 1/24), non-proliferative diabetic retinopathy (8.3%, 2/24), and age-related macular degeneration (45.8%, 11/24). The handheld camera successfully screened 60% (3/5) of patients with mobility issues. Overall, 90% (17/19) of patients rated their experience as either "brilliant" or "really good".
This pilot project demonstrated the necessity for routine eye care in the elderly and the potential for widespread implementation of teleophthalmology in long-term care facilities. With only 14.3% (4/28) of patients unable to be imaged, this program offers a feasible, patient-friendly alternative to in-clinic screening. Future policies and practices in teleophthalmology should consider the unique needs of long-term care residents and the potential for reducing healthcare disparities through such a program.
报告多伦多远程视网膜筛查项目在一家老年长期护理机构试点扩展的结果及可行性。
2022年4月1日至2022年7月1日期间,对患有II型糖尿病(DM)的长期护理患者进行了筛查。通过调查收集人口统计学和健康数据。
共筛查了28名患者,其中85.7%成功进行了视网膜成像。在成像患者中,8.3%(2/24)需要紧急随访。发现的病变包括未控制的青光眼(4.1%,1/24)、非增殖性糖尿病视网膜病变(8.3%,2/24)和年龄相关性黄斑变性(45.8%,11/24)。手持相机成功筛查了60%(3/5)有行动不便问题的患者。总体而言,90%(17/19)的患者将他们的体验评为“出色”或“非常好”。
该试点项目证明了老年人常规眼部护理的必要性以及远程眼科在长期护理机构广泛实施的潜力。由于只有14.3%(4/28)的患者无法成像,该项目为门诊筛查提供了一种可行的、对患者友好的替代方案。远程眼科未来的政策和实践应考虑长期护理居民的独特需求以及通过此类项目减少医疗保健差距的潜力。