Endophthalmitis following intravitreal injections administered by junior medical officers in rural Western Australia

IF 4.9 2区医学 Q1 OPHTHALMOLOGY Clinical and Experimental Ophthalmology Pub Date : 2024-07-25 DOI:10.1111/ceo.14421

Jackson Chee Chea Lee BMed, Hessom Razavi FRANZCO, Marcel Maziyar Nejatian MD, Jocelyn Drinkwater PhD, Angus Warwick Turner FRANZCO

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Abstract

Background

Patients in rural Australia have limited access to intravitreal treatments due to a maldistribution of the ophthalmology workforce. To improve access, a novel outreach service model was implemented whereby junior medical staff administered intravitreal injections under a supervising ophthalmology consultant. This model involves outreach visits in hospitals, mobile clinics and a remote hub with intravitreal injections administered by junior doctors overseen by an ophthalmologist. The article explores the safety of this approach with respect to the rate of post-injection endophthalmitis.

Methods

A retrospective audit was conducted by the Lions Outback Vision outreach ophthalmology service from 2017 to mid-2023. The number of injections, locations, diagnoses, intravitreal agents used, designation of administering doctor and cases of endophthalmitis were reviewed.

Results

A 12 632 intravitreal injections were administered across 32 locations throughout rural Western Australia in the 6.5-year period. Three cases of endophthalmitis occurred representing a rate of 0.0237%.

Conclusion

The rate of endophthalmitis in the outreach service is comparable to other centres. The outreach model with supervising ophthalmology consultant support in person or via telehealth and administration of injections by junior medical staff has improved access for underserved or marginalised populations.

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西澳大利亚农村地区初级医务人员进行玻璃体内注射后引发眼内炎。

背景：由于眼科医务人员分布不均，澳大利亚农村地区的患者接受玻璃体内治疗的机会有限。为了改善患者的就医条件，我们采用了一种新颖的外展服务模式，即由初级医务人员在眼科顾问的指导下进行玻璃体内注射。这种模式包括在医院、流动诊所和远程中心进行外展访问，由初级医生在眼科医生的监督下进行玻璃体内注射。文章从注射后眼内炎的发生率方面探讨了这种方法的安全性：从 2017 年到 2023 年中期，Lions Outback Vision 外展眼科服务进行了一次回顾性审计。对注射次数、地点、诊断、使用的玻璃体内药剂、指定的管理医生和眼底病病例进行了审查：在 6.5 年的时间里，西澳大利亚州农村地区的 32 个地点共进行了 12 632 次玻璃体内注射。发生了三例眼内炎，发生率为 0.0237%：结论：外联服务的眼底病发生率与其他中心相当。外展模式由眼科顾问亲自或通过远程医疗提供指导支持，并由初级医务人员进行注射，这改善了服务不足或边缘化人群的就医条件。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical and Experimental Ophthalmology 医学-眼科学

CiteScore

7.60

自引率

12.50%

发文量

150

审稿时长

4-8 weeks

期刊介绍： Clinical & Experimental Ophthalmology is the official journal of The Royal Australian and New Zealand College of Ophthalmologists. The journal publishes peer-reviewed original research and reviews dealing with all aspects of clinical practice and research which are international in scope and application. CEO recognises the importance of collaborative research and welcomes papers that have a direct influence on ophthalmic practice but are not unique to ophthalmology.