Division of Ophthalmology, Tel Aviv Medical Center, affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Ophthalmologica. 2022;245(4):385-392. doi: 10.1159/000522273. Epub 2022 Feb 3.
The increasing high prevalence of neovascular age-related macular degeneration (nvAMD) in the aging population combined with the need for frequent monitoring and treatment for many years, especially in the COVID-19 era, raises the need to establish an effective, reliable, and safe follow-up and treatment model. This study evaluates the difference in treatment decisions comparing between the gold standard face-to-face clinical examination and virtual evaluation approach based only on visual acuity (VA) and optical coherence tomography (OCT) scans without clinical fundoscopic examination in nvAMD patients.
A single-center retrospective cohort study was conducted that compared an original "face-to-face" visit treatment decision regarding the need for anti-vascular endothelial growth factor drug, interval, and treatment regimen based on routine VA, spectral domain OCT imaging, and dilated fundus examination to two "virtual" treatment decisions based on evaluation of OCT scans and previous medical records before and after revealing VA data on the same nvAMD patients eyes.
About 169 eyes of 114 patients were included in the study. Forty-nine patients (43%) suffered from bilateral nvAMD and had both eyes included in the study. Agreement between the "face-to-face visit treatment decision" and "virtual treatment decision" was noted in 74.6% and 71.6% eyes before and after revealing the patient's VA in the study visit, respectively.
Virtual evaluation results in similar treatment decisions for nvAMD patients compared to standard face-to-face clinical examination.
随着人口老龄化，新生血管性年龄相关性黄斑变性（nvAMD）的发病率不断上升，加之多年来需要频繁监测和治疗，尤其是在 COVID-19 时代，这就需要建立一种有效、可靠和安全的随访和治疗模式。本研究评估了 nvAMD 患者在比较基于视力（VA）和光学相干断层扫描（OCT）扫描且不进行临床眼底检查的金标准面对面临床检查与虚拟评估方法时，治疗决策的差异。
进行了一项单中心回顾性队列研究，该研究比较了原始的“面对面”就诊时根据常规 VA、谱域 OCT 成像和散瞳眼底检查做出的关于是否需要抗血管内皮生长因子药物、间隔和治疗方案的治疗决策，以及两种“虚拟”治疗决策，即基于同一 nvAMD 患者眼 OCT 扫描和之前病历的评估，以及在揭示 VA 数据前后进行评估。
研究纳入了 114 例患者的 169 只眼。49 例（43%）患者患有双侧 nvAMD，双眼均纳入研究。在研究就诊时分别揭示患者 VA 之前和之后，“面对面就诊治疗决策”与“虚拟治疗决策”之间的一致性分别为 74.6%和 71.6%。
与标准的面对面临床检查相比，虚拟评估可对 nvAMD 患者做出类似的治疗决策。
