Diagnostic utility of an automated fundus-OCT camera in the emergency department: a retrospective review.

BACKGROUND

Posterior segment pathology can be challenging to diagnose and may lead to irreversible vision loss. Ocular imaging modalities are limited in the emergency department (ED) where many posterior segment emergencies present. Automated fundus-OCT cameras are emerging as a rapid, user-friendly and cost-effective tool in the ED.

METHODS

Fundus and OCT images were taken by residents as needed for patients undergoing ophthalmology consultation in an academic ED in 2023. Image type and quality were graded on a scale of 1 to 3 (poor, adequate, good). Medical records were reviewed to record relevant patient characteristics. Statistical analysis was performed using unequal variances T-test to compare patients with poor and at least adequate photo quality.

RESULTS

288 patients were imaged with the fundus-OCT camera over 12 months. Camera utilization increased at the start of the academic year, then decreased towards the end of the academic year. Adequate diagnostic quality images were taken in 92% of color photos and 94% of OCT images. The odds of poor image quality were significantly higher in patients presenting with logMAR > 1.0 (OR 8.07, 95% CI 3.28-19.86, p < 0.001) and age > 65 (OR 4.69, 95% CI 1.94-11.34, p < 0.001).

CONCLUSIONS

Fundus photography and OCT are emerging as viable imaging modalities in the ED where access to ophthalmic expertise and equipment has traditionally been limited. Automated fundus-OCT cameras can offer high quality images that may facilitate rapid and accurate diagnosis of posterior segment pathology.