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Devangna Bhatia, Jing Xian Lee, Vina Manjunath, James S Talks; Management outcomes from using ultra-widefield and OCT imaging for a virtual medical retina clinic. Invest. Ophthalmol. Vis. Sci. 2019;60(9):5454.
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© ARVO (1962-2015); The Authors (2016-present)
Referrals to Hospital Eye Services (HES) are on the rise. In this study, we evaluated the use of a medical retina virtual clinic (MRVC), in which multimodal ultra-widefield and optical coherence tomography imaging for assessing all new medical retina referrals, where the need for urgent treatment was not clear from the referral, was performed.
Referral letters to the HES from, diabetic eye screening, Optometrists and GPs were assessed and required imaging specified. On arrival specified questions were asked, visual acuity recorded and imaging performed. Two consultants reviewed the information and images and provided a final diagnosis and management plan. A retrospective analysis of the diagnosis and management plans from between March 2018 and August 2018 was performed, including reasons for face-to-face (F2F) clinic appointment requests.
557 new referrals attended the virtual clinic. The most common diagnosis was diabetic eye disease (50.3%). 167 (30.0%) were discharged to their optometrist, 166 (29.8%) were followed up in the virtual clinic, and 224 (40.2%) were booked a F2F clinic appointment (Urgent/Routine). Of these 114 (51.3% of F2F; 20% of total seen) required treatment but only 39/114 urgent treatment. Urgent F2F appointments took place on average 11.0 days after virtual clinic attendance. No patient was recalled due to poor image quality. It was not possible to make a definite diagnosis in 6.8% as no pathology was seen in these images.
The MRVC, using a short-defined questionnaire and multimodal imaging, was an effective way of diagnosing and triaging medical retina referrals to allow those patients needing treatment to be seen more promptly in the medical retina service.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.
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