Kaplan Richard I, Chen Masako, Gupta Meenakashi, Rosen Richard B
Department of Ophthalmology, New York Eye and Ear Infirmary of Mt. Sinai, New York City, New York, USA.
BMJ Open Ophthalmol. 2019 Jan 20;4(1):e000187. doi: 10.1136/bmjophth-2018-000187. eCollection 2019.
BACKGROUND/AIMS: Optical coherence tomography (OCT) has become standard of care in the diagnosis and management of a myriad of retinal and optic nerve pathology. Access to diagnostic equipment and skilled imaging personnel in the after-hours setting is often limited. We examined the utility and diagnostic indications for automated OCT in a high-volume after-hours clinic within an eye institute.
OCT images obtained over a period of 15 months were reviewed in the context of electronic patient records. Residents and fellows were surveyed regarding their experience with the OCT and its value in emergency patient management.
202 patients and 359 eyes were examined. Complaints prompting imaging included flashes/floaters, metamorphopsia, decreased vision and scotomas. Diagnoses included vascular occlusion, retinal detachment, macular hole, cystoid macular oedema and central serous retinopathy. Of the 25 residents and fellows surveyed, most agreed that the OCT that facilitated delivery of optimal urgent management. OCT also aided in the triage of patients to specialty clinics.
Expanded access to automated OCT in the urgent care setting shows promise for improving the accuracy and timeliness of diagnosis, which can be critical for optimising patient outcomes. OCT also provides clear, immediate documentation of pathology for substantiating medical decision-making.
背景/目的：光学相干断层扫描（OCT）已成为众多视网膜和视神经疾病诊断与管理的标准医疗手段。在非工作时间，获得诊断设备和专业成像人员的机会往往有限。我们在一家眼科机构的大量非工作时间门诊中，研究了自动OCT的实用性和诊断指征。
结合电子病历，回顾了15个月内获取的OCT图像。就住院医师和研究员对OCT的使用体验及其在急诊患者管理中的价值进行了调查。
共检查了202例患者和359只眼。促使进行成像检查的主诉包括闪光/飞蚊症、视物变形、视力下降和暗点。诊断结果包括血管阻塞、视网膜脱离、黄斑裂孔、黄斑囊样水肿和中心性浆液性视网膜病变。在接受调查的25名住院医师和研究员中，大多数人认为OCT有助于提供最佳的紧急治疗。OCT还有助于将患者分诊至专科门诊。
在紧急护理环境中扩大自动OCT的使用范围，有望提高诊断的准确性和及时性，这对于优化患者治疗效果至关重要。OCT还能提供清晰、即时的病理记录，以支持医疗决策。
