Abstract
Purpose :
Diabetic retinopathy (DR) is currently an epidemic in the rural Southeast, where many patients are uninsured and lack the ability to receive any treatment. Our purpose was to evaluate the efficacy of a bimonthly (Saturday), free for service, same day treatment for patients with regards to visual outcomes, follow up rates, and satisfaction with care.
Methods :
After IRB approval, a retrospective chart review and satisfaction survey of 96 consecutive patients from 1/1/2018 to 5/1/2019 was performed. Patients were primarily referred from charity primary care clinics and eye care providers in West Alabama and East Mississippi. Patients were treated by a six-person volunteer staff of retina care providers. Assessments included mean pre- and post-treatment visual acuity, number of intravitreal injections, number of focal and PRP lasers, number of clinic visits, percentage lost to follow up (LTFU), and a patient satisfaction survey.
Results :
21/96 (21%) patients received treatment, including 36 eyes with diabetic macular edema (DME) and 15 eyes with proliferative diabetic retinopathy (PDR). Mean numbers of injections (Bevacizumab), focal lasers, and PRP lasers were 1.97, 1.06, and 1.73 respectively per eye. For fear of patients becoming LTFU, all eyes received both injections and laser in the same eye for both DME and PDR. The mean number of clinic visits was 3.15 over 16 months, while 21% of patients were LTFU. Mean pre-treatment visual acuity was 0.428 Logmar (20/54), and post-treatment vision was 0.384 Logmar (20/48). The patient satisfaction survey revealed patients had high overall satisfaction (4.95/5) (p<0.001), and valued the following: communication (4.77/5) (p<0.001), rural clinic location (4.68/5) (p<0.001), and scheduling on Saturday (4.09/5) (p<0.001).
Conclusions :
To meet the demands of an epidemic of DR and blindness in the rural Southeast uninsured population, a nonprofit bimonthly free rural eye clinic with minimal staff can provide same day service with stabilization of vision using both injections and laser same day and simultaneously, achieve a good LTFU rate, and receive a high overall patient satisfaction.
This is a 2020 ARVO Annual Meeting abstract.