Mesh : Adult Aged Choroid / pathology Choroid Neoplasms / diagnosis Female Fluorescein Angiography Follow-Up Studies Fundus Oculi Humans Iris / pathology Iris Neoplasms / diagnosis Male Middle Aged Nevus, Pigmented / diagnosis Ophthalmology / methods Ophthalmoscopy Pilot Projects Reproducibility of Results Retrospective Studies Telemedicine / methods Time Factors Tomography, Optical Coherence Ultrasonography

来  源:   DOI:10.1016/j.jcjo.2017.11.021   PDF(Sci-hub)

Abstract:
To investigate the validity and safety of tele-ophthalmology evaluations as a clinical assessment tool when performed by an ophthalmologist to detect lesion growth in patients with low-, medium-, and high-risk choroidal and iris nevi.
Retrospective observational pilot study.
Consecutive patients with low-/medium-/high-risk choroidal or iris nevi who underwent tele-oncology examinations over 5 months. All patients had a dilated fundus or anterior segment photography, A- and B-scan ultrasonography or ultrasound biomicroscopy (UBM), and spectral domain optical coherence tomography (SD-OCT) depending on the nature of their lesion. Patients who followed up with in-person examinations had an additional ophthalmoscopic examination.
Seventy-one eyes of 71 patients were included. The diagnoses were 47 low-risk choroidal nevi, 10 medium-risk choroidal nevi, 5 high-risk choroidal nevi, and 9 iris nevi. The tele-ophthalmology examinations found a sensitivity of 100%, specificity of 92%, positive predictive value of 57%, and negative predictive value of 100% to detect growth of a lesion.
Tele-ophthalmology assessment for choroidal and iris nevi is a sensitive clinical tool to evaluate growth with 100% sensitivity and negative predictive value when performed by trained ultrasound technicians and reviewed by an ophthalmologist with expertise in ocular oncology. It has the potential to alleviate patient- and physician-related treatment burden.
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