Azzopardi Matthew, Gridhar Sneha, Tsika Chrysanthi, Koutsocheras Georgios, Katzakis Michail, Demir Bahar, Rahman Waheeda, Heng Ling Zhi, Chong Yu Jeat, Logeswaran Abison
Moorfields Eye Hospital NHS Foundation Trust, City Road, London EC1V 2PD, UK.
Birmingham and Midland Eye Centre, Birmingham B18 7QH, UK.
J Clin Med. 2025 May 8;14(10):3270. doi: 10.3390/jcm14103270.
Virtual clinics (VCs) have proven to be an effective solution for the increasing strain on Medical Retina (MR) services, although imaging quality issues (IQIs) persist. Our aim was to compare the quality of two ultra-wide-field (UWF) imaging modalities (Optos and Clarus) in real-world MR-VC settings. We conducted a real-world, prospective study. Data were collected from 6 Moorfields NHS Trust MR-VCs between September and October 2024. We obtained patient demographics and characteristics, primary diagnosis, UWF imaging types and images obtained, and follow-up outcomes. Optos (California RG/RGB, and Monaco) was used for 56.7% ( = 152) and Zeiss Clarus 500 for 43.3% ( = 116) of the total cohort ( = 268). No statistically significant difference ( = 0.14) was found between the two in terms of the rates of IQIs. FAF ( = 0.001) acquisition was significantly higher when Optos was used. Of the patients affected by IQIs, 10 were examined in a face-to-face clinic (F2FC). No difference in IQI rates was observed when pathology-related poor image quality was considered ( = 0.561). A significantly ( = 0.001) higher rate of F2F follow-ups was found for red-flag pathologies and unexplained vision loss, with a statistically significantly higher rate of virtual follow-ups for non-red-flag pathologies ( = 0.001). A total of 7.5% of the clinical decisions were impacted by IQIs; 11.1% of F2FC follow-ups. Neither UWF imaging modality type was inferior in terms of IQI rates. FAF acquisition was higher with Optos, likely representing greater user-dependency for Clarus. The outcomes were not influenced by FAF acquisition, indicating that routine acquisition is not required in MR-VCs and instead should be obtained when clinically required.
虚拟诊所（VCs）已被证明是缓解医学视网膜（MR）服务日益增加压力的有效解决方案，尽管成像质量问题（IQIs）仍然存在。我们的目的是在实际的MR-VC环境中比较两种超广角（UWF）成像模式（Optos和Clarus）的质量。我们进行了一项实际的前瞻性研究。2024年9月至10月期间，从6个摩尔菲尔德国民保健服务信托基金的MR-VC收集了数据。我们获取了患者的人口统计学和特征、初步诊断、UWF成像类型和获得的图像以及随访结果。在整个队列（n = 268）中，56.7%（n = 152）使用了Optos（加利福尼亚RG/RGB和摩纳哥），43.3%（n = 116）使用了蔡司Clarus 500。在IQIs发生率方面，两者之间未发现统计学上的显著差异（P = 0.14）。使用Optos时，自发荧光（FAF）（P = 0.001）采集显著更高。在受IQIs影响的患者中，有10人在面对面诊所（F2FC）接受了检查。当考虑与病理相关的图像质量差时，未观察到IQI发生率的差异（P = 0.561）。对于红旗病变和原因不明的视力丧失，面对面随访的发生率显著更高（P = 0.001），对于非红旗病变，虚拟随访的发生率在统计学上显著更高（P = 0.001）。共有7.5%的临床决策受到IQIs的影响；F2FC随访的这一比例为11.1%。就IQI发生率而言，两种UWF成像模式类型均不逊色。Optos的FAF采集更高，这可能表明Clarus对用户的依赖性更大。结果不受FAF采集的影响，这表明在MR-VCs中不需要常规采集，而应在临床需要时进行采集。
