Anderson Roger S, Roark Mark, Gilbert Rose, Sumodhee Dayyanah
Centre for Optometry and Vision Science, Ulster University, Coleraine, UK
NIHR Moorfields Biomedical Research Centre, London, UK.
Br J Ophthalmol. 2025 Jan 28;109(2):228-236. doi: 10.1136/bjo-2024-325310.
BACKGROUND/AIMS: Recent decades have seen significant advances in both structural and functional testing of retinal disease. However, the current clinical value of specific testing modalities, as well as future trends, need to be clearly identified in order to highlight areas for further development in routine care and clinical trials.
We designed a modified two-round Delphi study to obtain the opinion of a multidisciplinary group of 33 international experts involved in the field of retinal disease management/research to determine the level of agreement and consensus regarding the value and performance of specific structural and functional testing methods for retinal disease. On a Likert scale, a median of 1-2 indicated disagreement with the statement, and 5-6 indicated agreement with the statement. An IQR of ≤2 indicated consensus in the responses. Several questions also allowed comments on responses.
There was overall agreement that structural testing currently predominates for detection and monitoring. There was moderate agreement that functional testing remains important and will continue to do so in the future because it provides complementary information. Certain respondents considered that properly designed and applied psychophysical tests are as reliable and repeatable as structural observations and that functional changes are the most important in the long run. Respondents considered future care and research to require a combination of structural and functional testing with strong consensus that the relative importance will depend on disease type and stage.
The study obtained important insights from a group of international experts regarding current and future needs in the management of retinal disease using a mix of quantitative and qualitative approaches. Responses provide a rich range of opinions that will be of interest to researchers seeking to design tests for future patient care and clinical trials.
背景/目的：近几十年来，视网膜疾病的结构和功能检测都取得了重大进展。然而，为了突出常规护理和临床试验中需要进一步发展的领域，需要明确特定检测方式的当前临床价值以及未来趋势。
我们设计了一项经过改进的两轮德尔菲研究，以获取33位参与视网膜疾病管理/研究领域的国际多学科专家的意见，以确定关于视网膜疾病特定结构和功能检测方法的价值和性能的一致程度和共识。在李克特量表上，中位数为1 - 2表示不同意该陈述，5 - 6表示同意该陈述。四分位距≤2表示回答中达成共识。几个问题还允许对回答进行评论。
总体上达成的共识是，目前结构检测在疾病检测和监测中占主导地位。对于功能检测仍然很重要且未来也将继续如此这一点，存在中度共识，因为它能提供补充信息。一些受访者认为，设计合理且应用得当的心理物理学测试与结构观察一样可靠且可重复，并且从长远来看功能变化是最重要的。受访者认为未来的护理和研究需要结构和功能检测相结合，并且强烈认同相对重要性将取决于疾病类型和阶段。
该研究通过定量和定性相结合的方法，从一组国际专家那里获得了关于视网膜疾病管理当前和未来需求的重要见解。这些回答提供了丰富多样的观点，对于寻求为未来患者护理和临床试验设计检测方法的研究人员来说将很有价值。
