Visual Impairment from Uncorrected Refractive Error among Participants in a Novel Program to Improve Eye Care Access among Low-Income Adults in Michigan.
Visual Impairment from Uncorrected Refractive Error among Participants in a Novel Program to Improve Eye Care Access among Low-Income Adults in Michigan.
复制标题
一项旨在改善密歇根州低收入成年人眼部护理机会的新计划的参与者因未矫正屈光不正而造成的视力障碍。
DOI：
10.1016/j.ophtha.2023.09.025
复制
发表时间：
2024
期刊：
影响因子：
13.7
通讯作者：
Newman-Casey,PaulaAnne
中科院分区：
文献类型：
--
作者：
Killeen,OliviaJ;Niziol,LeslieM;Elam,AngelaR;Bicket,AmandaK;John,Denise;Wood,SarahDougherty;Musch,DavidC;Zhang,Jason;Johnson,Leroy;Kershaw,Martha;Woodward,MariaA;Newman-Casey,PaulaAnne
目的评估未矫正屈光不正（URE）导致的视力损害（VI）率，以及接受密歇根州青光眼筛查和远程医疗眼健康干预（MI-SIGHT）计划的低收入患者与人口统计学和社会经济因素的相关性。设计横断面研究。参与者年龄≥ 18岁，无急性眼部症状。方法MI-SIGHT项目参与者接受基于远程医疗的眼病筛查，并通过在线眼镜店订购眼镜。根据屈光不正（RE）状态对参与者进行分类：来自URE的VI（视力[PVA] ≤ 20/50;最佳矫正视力[BCVA] ≥ 20/40），无VI的URE（PVA，≥ 20/40; BCVA ≥ 2线改善），以及无或充分矫正的RE（PVA，≥ 20/40; BCVA < 2线改善）。使用方差分析、Kruskal-Wallis、卡方和Fisher精确检验比较各组患者的人口统计学资料、自我报告的视觉功能和通过该程序获得的眼镜满意度。主要指标PVA、BCVA和VI（定义为PVA≤ 20/50）。结果在第一年参加MI-SIGHT项目的1171名参与者中，平均年龄为55.1岁（SD= 14.5），37.7%为男性，54.1%为黑人，1166名（99.6%）同时测量了PVA和BCVA。在120名参与者（10.3%）中观察到VI; 96名参与者（8.2%）因URE而发生VI，168名参与者（14.4%）因URE而无VI，878名参与者（75.3%）无RE或RE得到充分纠正。与没有RE或RE得到充分纠正的参与者相比，RE导致VI的参与者中报告具有大学学位的百分比较小，报告收入<10 000美元的百分比较大（分别为3.2%和14.2%[P= 0.02]; 45.5%和21.6%[P< 0.0001]）。视力最差的是因URE导致视力下降的受试者，其次是无视力下降的URE受试者，然后是无RE或RE得到充分矫正的受试者（9项国家眼科研究所视觉功能问卷综合评分分别为67.3±19.6 vs. 77.0±14.4 vs. 82.2±13.3; P< 0.0001）。总的来说，71.2%（n= 830）的人订购了眼镜，平均价格为36.80 ± 32.60美元; 97.7%的人对眼镜感到满意。结论：在2个服务于低收入社区的诊所中，URE是VI的主要原因，并与视力相关的生活质量降低有关。一家价格较低的在线眼镜店使低收入患者能够获得眼镜。财务披露专有或商业披露可在本文末尾的脚注和披露中找到。
Purpose To assess the rate of visual impairment (VI) from uncorrected refractive error (URE) and associations with demographic and socioeconomic factors among low-income patients presenting to the Michigan Screening and Intervention for Glaucoma and Eye Health through Telemedicine (MI-SIGHT) program. Design Cross-sectional study. Participants Adults≥ 18 years without acute ocular symptoms. Methods MI-SIGHT program participants received a telemedicine-based eye disease screening and ordered glasses through an online optical store. Participants were categorized based on refractive error (RE) status: VI from URE (presenting visual acuity [PVA],≤ 20/50; best-corrected visual acuity [BCVA],≥ 20/40), URE without VI (PVA,≥ 20/40;≥ 2-line improvement to BCVA), and no or adequately corrected RE (PVA,≥ 20/40;< 2-line improvement to BCVA). Patient demographics, self-reported visual function, and satisfaction with glasses obtained through the program were compared among groups using analysis of variance, Kruskal–Wallis, chi-square, and Fisher exact testing. Main Outcome Measures PVA, BCVA, and presence of VI (defined as PVA≤ 20/50). Results Of 1171 participants enrolled in the MI-SIGHT program during the first year, average age was 55.1 years (SD= 14.5), 37.7% were male, 54.1% identified as Black, and 1166 (99.6%) had both PVA and BCVA measured. VI was observed in 120 participants (10.3%); 96 had VI from URE (8.2%), 168 participants (14.4%) had URE without VI, and 878 (75.3%) had no or adequately corrected RE. A smaller percentage of participants with VI resulting from URE reported having a college degree, and a larger percentage reported income< $10 000 compared with participants with no or adequately corrected RE (3.2% vs. 14.2%[P= 0.02]; 45.5% vs. 21.6%[P< 0.0001], respectively). Visual function was lowest among participants with VI from URE, followed by those with URE without VI, and then those with no or adequately corrected RE (9-item National Eye Institute Visual Function Questionnaire composite score, 67.3±19.6 vs. 77.0±14.4 vs. 82.2±13.3, respectively; P< 0.0001). In total, 71.2%(n= 830) ordered glasses for an average cost of $36.80±$32.60; 97.7% were satisfied with their glasses. Conclusions URE was the main cause of VI at 2 clinics serving low-income communities and was associated with reduced vision-related quality of life. An online optical store with lower prices made eyeglasses accessible to low-income patients. Financial Disclosure (s) Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.