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Remote ophthalmology with a smartphone adapter handled by nurses for the diagnosis of eye posterior pole pathologies during the COVID-19 pandemic.

Authors :
González-Márquez F
Luque-Romero L
Ruiz-Romero MV
Castillón-Torre L
Hernández-Martínez FJ
Olea-Pabón L
Moro-Muñoz S
García-Díaz RDM
García-Garmendia JL
Source :
Journal of telemedicine and telecare [J Telemed Telecare] 2023 Jul; Vol. 29 (6), pp. 474-483. Date of Electronic Publication: 2021 Feb 18.
Publication Year :
2023

Abstract

Introduction: The use of smartphones to provide specialist ophthalmology services is becoming a more commonly used method to support patients with eye pathologies. During the COVID-19 pandemic, demand for telehealth services such as tele-ophthalmology, is increasing rapidly.<br />Methods: In 2019, the agreement between diagnostic tests was investigated by comparing the diagnostic performance for eye posterior pole pathologies of the images obtained by a smartphone coupled to a medical device known as open retinoscope (OR), handled by a nurse and subsequently assessed by an ophthalmologist versus the images obtained by an ophthalmologist using a slit lamp associated to a 76 diopter indirect ophthalmic lens (Volk Super FieldVR ) (SL-IOL) at the outpatient department of a hospital. The OR used in this study worked with a 28 diopter indirect lens.<br />Results: An examination of 151 dilated eyes (79 adult patients, mean age of 66.7 years, 59.5% women) was conducted. Sensitivity was 98.9%, specificity was 89.8%, the positive predictive value was 93.8% and the negative predictive value was 98.2%. The kappa index between both tests was 0.90 (95% CI: 0.83-0.97) in basic diagnosis, 0.81 (95% CI: 0.74-0.89) in syndromic diagnosis (13 categories) and 0.70 (95% CI: 0.62-0.77) in advanced diagnosis (23 categories).<br />Discussion: Images obtained by a nurse using a smartphone coupled to the OR and subsequently assessed by an ophthalmologist showed a high diagnostic performance for eye posterior pole pathologies, which could pave the way for remote ophthalmology systems for this patient group.

Details

Language :
English
ISSN :
1758-1109
Volume :
29
Issue :
6
Database :
MEDLINE
Journal :
Journal of telemedicine and telecare
Publication Type :
Academic Journal
Accession number :
33599527
Full Text :
https://doi.org/10.1177/1357633X21994017