Browning Samuel D, Costello Julia M, Dunn Hamish P, Fraser Clare L
Faculty of Medicine, The University of New South Wales, New South Wales, Australia.
Port Macquarie Eye Centre, Port Macquarie, New South Wales, Australia.
Curr Neurol Neurosci Rep. 2025 Apr 11;25(1):30. doi: 10.1007/s11910-025-01417-7.
The ocular fundus reveals a wealth of pathophysiological findings which should change patient management in the emergency room (ER). Traditional fundoscopy has been technically challenging and diagnostically inaccurate, but technological advances in non-mydriatic fundus photography (NMFP) have facilitated clinically meaningful fundoscopy. This review presents an update on the literature regarding NMFP and its application to the ER, illustrating pivotal publications and recent advances within this field.
NMFP's application in the ER is demonstrably feasible and seamlessly integrates into emergency physicians' (EP) diagnostic workflows in a clinically meaningful and time efficient manner. The images of the ocular fundus (OF) generated by NMFP are consistently high quality, allowing a greater diagnostic accuracy to EP and ophthalmology interpreters alike. Digital NMFP images facilitate effective ophthalmology input via telemedicine to review the images in the ER. NMFP has been shown to change management decisions in the ER, improving patient and departmental outcomes. Interpretation of fundus images remains a medical education challenge, and early research highlights the potential for artificial intelligence (AI) image systems of NMFP to augment image interpretation in the ER. NMFP can change the ER approach to OF assessment, however the factors limiting its routine implementation need further consideration. There is potential for AI to contribute to NMFP image screening systems to augment EPs diagnostic accuracy.
眼底可揭示大量病理生理结果，这些结果应改变急诊室（ER）的患者管理。传统的眼底镜检查在技术上具有挑战性且诊断不准确，但非散瞳眼底摄影（NMFP）的技术进步促进了具有临床意义的眼底镜检查。本综述介绍了有关NMFP及其在ER中的应用的文献更新，阐述了该领域的关键出版物和最新进展。
NMFP在ER中的应用显然是可行的，并且能够以具有临床意义且高效的方式无缝融入急诊医生（EP）的诊断工作流程。NMFP生成的眼底（OF）图像始终具有高质量，使EP和眼科解释人员都能获得更高的诊断准确性。数字NMFP图像有助于通过远程医疗获得有效的眼科意见，以便在ER中查看图像。已证明NMFP可改变ER中的管理决策，改善患者和科室的治疗结果。眼底图像的解读仍然是医学教育中的一项挑战，早期研究强调了NMFP的人工智能（AI）图像系统在增强ER中图像解读方面的潜力。NMFP可以改变ER对OF评估的方法，然而限制其常规实施的因素需要进一步考虑。AI有可能为NMFP图像筛查系统做出贡献，以提高EP的诊断准确性。
