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[慢性视网膜疾病的数字远程监测——一种临床未来工具?:慢性视网膜疾病的远程监测]

[Digital remote monitoring of chronic retinal conditions-A clinical future tool? : Remote monitoring of chronic retinal conditions].

作者信息

Terheyden Jan Henrik, Mauschitz Matthias M, Wintergerst Maximilian W M, Chang Petrus, Herrmann Philipp, Liegl Raffael, Ach Thomas, Finger Robert P, Holz Frank G

机构信息

Universitäts-Augenklinik Bonn, Venusberg-Campus 1, 53127, Bonn, Deutschland.

Augenzentrum Grischun, Chur, Schweiz.

出版信息

Ophthalmologie. 2024 Oct;121(10):826-834. doi: 10.1007/s00347-024-02109-2. Epub 2024 Sep 14.

Abstract

BACKGROUND

In view of the predicted increase in incidence and prevalence of chronic retinal diseases and undersupply of care in the population, telemedicine could contribute to reducing access barriers to healthcare and improving the results of treatment.

OBJECTIVE

A literature review on remote monitoring of chronic retinal diseases was carried out.

MATERIAL AND METHODS

The medical literature was searched for publications on remote monitoring of chronic retinal diseases. The results were compiled in a narrative overview.

RESULTS

The four main topics in the literature are: validation studies, implementation strategies, acceptance/target group analyses and health economic analyses. Remote monitoring systems are based on visual function tests, imaging or patient reports and have been particularly investigated in age-related macular degeneration (AMD) and diabetic eye disease (DED). Studies indicate positive effects regarding an optimization of clinical care and a favorable safety profile but randomized controlled trials are lacking for the majority of monitoring tools.

CONCLUSION

Remote monitoring could complement existing care structures for patients with chronic retinal diseases, especially AMD and DED. Promising systems are based on hyperacuity or optical coherence tomography, while patient-reported data are not commonly used; however, there is currently insufficient evidence justifying the use of remote monitoring systems in chronic retinal diseases in Europe and more research on the validation of remote monitoring systems is needed.

摘要

背景

鉴于预计慢性视网膜疾病的发病率和患病率将会上升,且人群中医疗服务供应不足,远程医疗有助于减少医疗保健的获取障碍并改善治疗效果。

目的

对慢性视网膜疾病的远程监测进行文献综述。

材料与方法

检索医学文献中关于慢性视网膜疾病远程监测的出版物。结果以叙述性综述的形式进行汇总。

结果

文献中的四个主要主题是:验证研究、实施策略、接受度/目标群体分析和卫生经济学分析。远程监测系统基于视觉功能测试、成像或患者报告,并且在年龄相关性黄斑变性(AMD)和糖尿病眼病(DED)方面得到了特别研究。研究表明,在优化临床护理和良好的安全性方面有积极作用,但大多数监测工具缺乏随机对照试验。

结论

远程监测可以补充慢性视网膜疾病患者(尤其是AMD和DED患者)现有的护理结构。有前景的系统基于超敏锐度或光学相干断层扫描,而患者报告的数据并不常用;然而,目前在欧洲,尚无足够证据证明在慢性视网膜疾病中使用远程监测系统的合理性,需要对远程监测系统的验证进行更多研究。

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