远程眼科会诊对青光眼检出效果影响的研究

目的探讨远程眼科会诊平台对青光眼患者检出率的作用。 方法回顾性病例系列研究。首都医科大学附属北京同仁医院眼科研究所建立远程眼科会诊中心,收集远程会诊中心患者和基础眼病筛查者。采用Pearson χ²检验,比较同期在北京进行的基础眼病筛查中青光眼的检出率,评价眼科会诊平台对青光眼检出效果的作用,并分析"青光眼"诊断的患者中早期青光眼所占的比例。 结果远程会诊平台共收集493 221例患者。其中,检索"青光眼"诊断患者11 538例,占2.34%;可疑青光眼者2174例,占0.44%;青光眼及可疑青光眼诊断的检出率为2.78%。其中,早期青光眼诊断在所有"青光眼"诊断中的构成比为12.50%。同一时期在北京某机关进行眼病筛查者20 861例,青光眼诊断检出417例,占1.79%;可疑青光眼诊断检出33例,占0.16%;青光眼及可疑青光眼诊断检出率为1.95%。其中,早期青光眼诊断在青光眼诊断中的构成比为33.60%。两种方式青光眼检出率比较,经Pearson χ²检验结果显示两者差异无统计学意义( χ²＝2.0,P>0.05)。 结论应用互联网技术及眼科影像诊断标准,通过远程眼科会诊平台,可实现与基础眼病筛查对青光眼检出等同的效果,且可以实现以信息技术流动代替患者或医师的流动。

The role of teleophthalmology consulting in improving glaucoma diagnosis in population

ObjectiveThe aim of this study was to explore the role of teleophthalmology consulting in improving glaucoma diagnosis. MethodsThis study was retrospective case series. Participants were included patients from the Center of Teleophthalmology Consultation and subjects from population-based eye screening. The Center of Teleophthalmology Consultation was established in Beijing Tongren Hospital, Beijing Institute of Ophthalmology. Patients were collected from the remote consultation platform and analyzed with the diagnosis of glaucoma patients. The detection rate of glaucoma in population-based ophthalmological screening undertaken in Beijing during the same period, was compared to the detection rate of glaucoma from the remote consultation platform. The role of ophthalmological consultation platform for glaucoma detection was analyzed. Glaucoma detection rates in patients from the Center of teleophthalmology consultation and population-based eye screeners were compared. The constituent ratio of mild glaucoma was calculated. ResultsA total of 493 221 subjects were collected from the Center of teleophthalmology consultation platform. Among them, 11 538 (2.34%) were diagnosed as glaucoma, 2174 (0.44%) were diagnosed as suspicious glaucoma, and the detection rate of glaucoma and suspicious glaucoma was 2.78%. During the same period, 20 861 subjects from the population-basedeye diseases screening in Beijing was enrolled in this study, 417 patients (1.79%) were diagnosed as glaucoma, 33 cases (0.16%) were diagnosed as suspicious glaucoma, and 1.95% were diagnosed as glaucoma and suspicious glaucoma. Pearson chi-square test showed no statistically significant difference in the detection rate of glaucoma between two groups of subjects ( χ²=2.0, P>0.05). The constituent ratio of mild glaucoma from the teleophthalmology consultation glaucoma patients was 12.5%, this constituent ratio was 33.6%in population-based screening glaucoma patients. ConclusionsUsing internet technology and ophthalmic image diagnostic criteria, the effect of glaucoma detection from the teleophthalmology consultation is equal to that of eye diseases screening in population. Therefore, the moving of patients or doctors can be replaced by the flow of information technology.