Manhattan Vision Screening and Follow-Up Study (NYC-SIGHT): optometric exam improves access and utilization of eye care services.
Manhattan Vision Screening and Follow-Up Study (NYC-SIGHT): optometric exam improves access and utilization of eye care services.
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曼哈顿视力筛查和随访研究 (NYC-SIGHT)：验光检查可改善眼科护理服务的获取和利用。
DOI：
10.1007/s00417-023-06344-2
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发表时间：
2024
期刊：
影响因子：
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通讯作者：
Hark,LisaA
中科院分区：
文献类型：
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作者：
Diamond,DanielF;Hirji,Sitara;Xing,SamanthaX;Gorroochurn,Prakash;Horowitz,JasonD;Wang,Qing;Park,Lisa;Harizman,Noga;Maruri,StefaniaC;Henriquez,DesireeR;Liebmann,JeffreyM;Cioffi,GeorgeA;Hark,LisaA
目的描述在基于社区的眼健康筛查背景下，验光评估对于检测影响视力的状况的好处，并确定与最近散瞳检查相关的因素。 方法 登记的参与者年龄在 40 岁及以上，独立生活在纽约市的经济适用住房开发区。眼睛健康筛查失败和现场研究验光师就诊的标准被定义为任一只眼睛的视力为 20/40 或更差、眼压为 23-29 mmHg 或眼底图像无法辨认。验光师使用松散镜片进行明显验光，并使用便携式裂隙灯和检眼镜进行非散瞳前段和后段眼部健康评估。记录人口统计数据、健康的社会决定因素、眼睛健康筛查结果以及可疑眼科疾病的发生率。为了确定与近期散瞳检查（本次统计分析的主要结果）相关的因素，我们进行了逐步多元逻辑回归。 结果 总共筛选了 708 名参与者，其中 308 名参加了验光检查；308 名参加了验光检查。平均年龄 70.7 ± 11.7 [标准差 (SD)] 岁。在这个亚群体中，70.1% 的人自认为是女性，54.9% 的人自认为是非裔美国人，39% 的人自认为是西班牙裔/拉丁裔，26.6% 的人自认为是多米尼加人； 78.2% (241/308) 在过去一年内没有接受过散瞳眼科检查，71.4% 表示他们没有眼科护理人员。逐步多元逻辑回归分析表明，自我报告患有白内障的参与者（比值比 (OR) 2.15；95% 置信区间 (CI) 1.03–4.47；p= 0.041）、自我报告患有青光眼/疑似青光眼的参与者（OR 5.60；95% CI） 2.02–15.43；p= 0.001）或以西班牙语为主要语言（OR 3.25；95% CI 1.48–7.11；p= 0.003）最近进行散瞳检查的几率较高。结论这项基于社区的筛查举措证明了验光检查在检测影响视力的情况方面的有效性，并确定了与最近进行散瞳检查相关的因素。验光师在增加高风险、服务不足人群获得眼科护理的机会方面发挥着至关重要的作用。试验注册ClinicalTrials.gov (NCT04271709)。
PurposeTo describe the benefits of optometric evaluation for detection of vision-affecting conditions in the context of community-based eye health screenings and identify factors associated with having a recent dilated eye exam.MethodsEnrolled participants were age 40 and older, living independently in affordable housing developments in New York City. Eye health screening failure and criteria for seeing the on-site study optometrist were defined as visual acuity 20/40 or worse in either eye, intraocular pressure 23–29 mmHg, or an unreadable fundus image. The optometrist conducted a manifest refraction using loose lenses and used a portable slit lamp and ophthalmoscope to perform a non-dilated anterior and posterior segment ocular health evaluation. Demographics, social determinants of health, eye health screening results, and rates of suspected ophthalmic conditions were recorded. To determine factors associated with having a recent dilated eye exam, which was the main outcome for this statistical analysis, a stepwise multivariate logistic regression was performed.ResultsA total of 708 participants were screened, 308 attended the optometric exam; mean age 70.7 ± 11.7 [standard deviation (SD)] years. Among this subgroup, 70.1% identified as female, 54.9% self-identified as African American, 39% as Hispanic/Latino, and 26.6% Dominican ethnicity; 78.2% (241/308) had not undergone a dilated eye exam within the last year, 71.4% reported they did not have an eye care provider. Stepwise multivariate logistic regression analysis indicated that participants who self-reported having cataracts (odds ratio (OR) 2.15; 95% confidence interval (CI) 1.03–4.47;p= 0.041), self-reported having glaucoma/glaucoma suspect (OR 5.60; 95% CI 2.02–15.43;p= 0.001), or spoke Spanish as their primary language (OR 3.25; 95% CI 1.48–7.11;p= 0.003) had higher odds of having a recent dilated eye exam.ConclusionsThis community-based screening initiative demonstrated the effectiveness of optometric exams in detecting vision-affecting conditions and identified factors associated with having a recent dilated eye exam. Optometrists play a vital role in increasing access to eye care for high-risk, underserved populations.Trial registrationClinicalTrials.gov (NCT04271709).