青光眼患者临床检查与监测的有效模式

D. A. Dorofeev, D. Baryshnikova, E. V. Kirilik, E. B. Parova
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引用次数: 0

摘要

开角型青光眼是一种慢性进行性视神经病变,在无其他眼病的情况下,以视神经头和视网膜神经纤维层的形态学改变为特征。为了评估青光眼的进展,纠正治疗方案或规定手术干预措施,控制青光眼过程的稳定,并长期保持视觉功能,定期体检是必要的。在规划监测就诊次数时,有必要仔细研究预后危险因素,因为它们在统计学上与青光眼的发生和进展相关。密切观察青光眼患者可降低视力器官发生不可逆变化的风险。患者的依从性在青光眼的进展中尤为重要。与其他需要终身治疗的慢性疾病相比,青光眼治疗的依从率相对较低。目前青光眼患者定期检查还没有有效的模式,因此这一方向需要改进和发展,无论是在患者检查的标准和时间上,还是在使用青光眼远程控制方法上。目前常规医疗检查的缺点是缺乏针对患者的个性化方法,地区眼科医生办公室缺乏设备,以及缺乏专门的青光眼办公室。新冠肺炎疫情期间紧张的流行病学形势使人们认识到,当面会诊和远程会诊(远程医疗)不能相互替代,但两者相结合具有成本效益,可以减少眼科资源分配不均,减轻医生负担,降低误诊率。由于眼科医院的关闭和在高等专科医疗机构就诊的等待时间增加,情况进一步恶化,这可能导致青光眼进展的患者增加,并给国家和患者本身造成经济负担。远程医疗应逐步引入日常实践,建议建立单一的青光眼患者数据库,跟踪青光眼的发展过程。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
An effective model of clinical examination and monitoring of glaucoma patients
Open-angle glaucoma is a chronic progressive optic neuropathy characterized by morphological changes in the optic nerve head and retinal nerve fibers layer in the absence of other eye diseases.Regular medical check-ups are necessary to assess the progression of glaucoma, to correct the treatment regimen or prescribe surgical interventions, to control the stabilization of the glaucoma process and to preserve visual functions for longer period. When planning the number of monitoring visits, it is necessary to carefully study the prognostic risk factors, since they are statistically associated with the development and progression of glaucoma. Closer observation of patients with glaucoma reduces the risk of irreversible changes in the organ of vision.Patient compliance is of particular importance in the progression of glaucoma. The adherence rate in the treatment of glaucoma is relatively lower compared to other chronic diseases that require lifelong treatment.Currently, there is no effective model of regular checkups for glaucoma patients, therefore this direction requires improvement and development, both in the standards and timing of patient examination, and in the use of remote methods of glaucoma control. The disadvantage of the current medical check-ups routine is the lack of individual approach to patients, lack of equipment in the offices of regional ophthalmologists, and lack of specialized glaucoma offices.The tense epidemiological situation during the Covid-19 pandemic, gave understanding that while in-person consultations and remote consultations (telemedicine) cannot replace each other, a combination of these methods is cost-effective, can reduce the uneven distribution of ophthalmic resources, reduce the burden on the doctor and the rate of misdiagnosis. The situation was aggravated by the closure of ophthalmological hospitals and an increase in the waiting time for consultation in higher specialized medical institutions, which probably entails an increase in patients with progression of the glaucomatous process and the economic burden on both the state and the patients themselves.Telemedicine should be gradually introduced into everyday practice, for which it is advisable to create a single database of glaucoma patients to track the glaucomatous process.
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