Netherlands Institute for Innovative Ocular Surgery, Rotterdam, the Netherlands.
Melles Cornea Clinic Rotterdam, the Netherlands.
Cornea. 2022 Mar 1;41(3):353-358. doi: 10.1097/ICO.0000000000002945.
The aim of this study was to describe a new type of medical device that allows for internet-enabled patient self-screening, without the aid of an ophthalmic professional, through biomicroscopy self-imaging and self-measurement of the best-corrected visual acuity (BCVA).
In this prospective nonrandomized comparative study, 56 patients were instructed to screen their own eyes using a custom-built e-Device containing miniaturized slitlamp optics and a visual acuity Snellen chart virtually projected at 20 ft. BCVA measurements were recorded, and biomicroscopic videos were scored for image quality of the anterior segment status on a scale from 1 to 5 (1 = poor and 5 = excellent) by a blinded observer.
After a short instruction, all patients were able to self-image their eyes and perform a self-BCVA measurement using the e-Device. Patient self-image quality with the e-Device scored on average 3.3 (±0.8) for videos (n = 76) and 3.6 (±0.6) for photographs (n = 49). Self-BCVA measurement was within 1 Snellen line from routine BCVA levels in 66 of 72 eyes (92%). When compared with conventional biomicroscopy, patient self-biomicroscopy allowed for recognition of the relevant pathology (or absence thereof) in 26 of 35 eyes (74%); 9 cases showed insufficient image quality attributed to device operating error (n = 6) and mild corneal edema and/or scarring (n = 3). Patient satisfaction with the device was 4.4 (±0.9).
An e-Device for combined BCVA self-measurement and biomicroscopy self-imaging may have potential as an aid in remote ophthalmic examination in the absence of an ophthalmic professional and may be considered for patients who are unable to visit an ophthalmic clinic for routine follow-up.
本研究旨在描述一种新型医疗设备，该设备可通过生物显微镜自拍和最佳矫正视力（BCVA）的自我测量，实现无需眼科专业人员协助的互联网支持的患者自我筛查。
在这项前瞻性非随机对照研究中，56 名患者被指导使用包含微型裂隙灯光学元件和虚拟投射在 20 英尺处的视力 Snellen 图表的定制 e-Device 自行筛查眼睛。记录 BCVA 测量值，并由一名盲法观察者对眼前节状态的生物显微镜视频进行评分，评分为 1 到 5 分（1=差，5=优）。
经过简短的指导，所有患者均能够使用 e-Device 自行拍摄眼睛照片并进行自我 BCVA 测量。患者使用 e-Device 自行拍摄的图像质量平均得分为 3.3（±0.8）（n=76）的视频和 3.6（±0.6）（n=49）的照片。72 只眼中有 66 只（92%）的自我 BCVA 测量值与常规 BCVA 水平相差 1 行。与传统的生物显微镜相比，患者的自我生物显微镜检查能够识别 26 只眼中的相关病变（或无病变）（74%）；9 例因设备操作失误（n=6）和轻度角膜水肿和/或瘢痕（n=3）导致图像质量不足。患者对该设备的满意度为 4.4（±0.9）。
一种用于联合 BCVA 自我测量和生物显微镜自拍的 e-Device 可能具有在没有眼科专业人员的情况下进行远程眼科检查的辅助作用，并且可以考虑用于无法前往眼科诊所进行常规随访的患者。
