Introduction

Consensus guidelines for the management of sarcoidosis recommend screening eye examinations for all patients, even in those without ocular symptoms. We aimed to determine the proportion of sarcoidosis patients that complete ophthalmologic evaluations and factors associated with their performance.

Methods

We identified patients with sarcoidosis using population health services data from Ontario, Canada between 1991 and 2019. Sarcoidosis was defined by ≥ 2 physician visits for sarcoidosis within a two-year period. Ophthalmologic evaluations were based on an optometrist or ophthalmologist visit within the year prior or two years following the diagnosis. We estimated correlations between the number of eye care professionals and proportion of sarcoidosis patients completing ophthalmologic assessments within regional health units. We evaluated for associations between ophthalmologic screening and patient characteristics using multivariable logistic regression.

Results

We identified 21,679 patients with sarcoidosis in Ontario. An ophthalmologic evaluation was performed in 14,751 (68.0%), with a similar number of individuals seeing ophthalmologists and optometrists (43.7% vs. 42.2%). The percentage of sarcoidosis patients undergoing an ophthalmologic evaluation within corresponding regional health units was moderately correlated with the number of practicing ophthalmologists (r = 0.64, p = 0.01), but not the number of optometrists (r = 0.08, p = 0.77). Patients who were older [OR per year 1.02 (95% CI 1.01–1.02), p < 0.001] and female [OR 1.54 (95% CI 1.44–1.63), p < 0.001] were more likely to complete ophthalmologic evaluations. Immigrants to Canada were less likely to undergo ophthalmologic assessments [OR 0.66 (95% CI 0.60–0.73), p < 0.001].

Conclusions

Most patients with sarcoidosis complete ophthalmologic examinations, though a substantial proportion does not. Young adults, men and immigrants were less likely to complete ophthalmologic evaluations. Limited access to ophthalmologists may at least in part explain why some sarcoidosis patients fail to complete ophthalmologic screening.

中文翻译：

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新诊断结节病患者的眼科评估：一项来自全民医疗保健系统的观察性研究

介绍

结节病管理共识指南建议对所有患者进行眼科检查，即使是没有眼部症状的患者。我们旨在确定完成眼科评估的结节病患者的比例以及与其表现相关的因素。

方法

我们使用 1991 年至 2019 年间加拿大安大略省的人口健康服务数据确定了结节病患者。结节病的定义是两年内因结节病就诊 ≥ 2 次。眼科评估基于诊断前一年或诊断后两年内的验光师或眼科医生访问。我们估计了眼保健专业人员的数量与区域卫生单位内完成眼科评估的结节病患者比例之间的相关性。我们使用多变量逻辑回归评估了眼科筛查与患者特征之间的关联。

结果

我们在安大略省确定了 21,679 名结节病患者。对 14,751 人 (68.0%) 进行了眼科评估，有相似数量的人去看眼科医生和验光师 (43.7% 对 42.2%)。在相应的区域卫生单位内接受眼科评估的结节病患者的百分比与执业眼科医生的数量中度相关（r = 0.64，p = 0.01），但与验光师的数量无关（r = 0.08，p = 0.77）。年龄较大的患者 [OR per year 1.02 (95% CI 1.01–1.02), p < 0.001] 和女性 [OR 1.54 (95% CI 1.44–1.63), p < 0.001] 更有可能完成眼科评估。加拿大移民不太可能接受眼科评估 [OR 0.66 (95% CI 0.60–0.73), p < 0.001]。

结论

大多数结节病患者都完成了眼科检查，但也有相当一部分没有。年轻人、男性和移民不太可能完成眼科评估。对眼科医生的有限访问至少可以部分解释为什么一些结节病患者未能完成眼科筛查。