一个远程咨询视网膜动脉封闭诊断协议
Gareth M C Lema1, Reade De Leacy2, Michael G Fara2
1Icahn School of Medicine at Mount Sinai, New York, New York; New York Eye and Ear Infirmary of Mount Sinai, New York, New York; James J. Peters VA Medical Center, Bronx, New York.
Ophthalmology
|February 13, 2024
概括
一个使用点照顾的新协议OCT和远程咨询成功诊断了视网膜动脉封闭. 这种方法改善了治疗患者的视力敏度,证明了它对眼科紧急情况的有用性.
科学领域:
- 眼科医生 眼科 眼科
- 神经学 神经学
- 医疗技术 医疗技术 医学技术
背景情况:
- 视网膜动脉封闭 (RAO) 是一种时间敏感的紧急情况,导致视力丧失.
- 快速诊断和治疗对于视力恢复至关重要.
- 目前的诊断途径可能会推迟及时干预.
研究的目的:
- 引入和评估一种用于诊断在护理地点的RAO的新方案.
- 评估使用光学一致性断层扫描 (OCT) 与远程咨询模型相结合的有效性.
- 确定本协议对治疗时间和患者结果的影响.
主要方法:
- 追溯案例系列评估一个新的诊断技术.
- 在中风中心/急诊室对突然单眼视力丧失的患者实施OCT.
- 视网膜服务通过远程解读OCT图像.
- 在符合条件的患者中使用动脉内组织等离子体激活剂 (IA-tPA) 治疗.
- 视敏度 (VA) 和治疗时间的评估.
主要成果:
- 在18个月内评估了59名患者;25名 (42%) 确认了RAO.
- 9名接受IA-tPA治疗的患者在24小时内显示出显著的VA改善 (logMAR 2.14至0.7,P=0.0001).
- 从呈现到治疗的平均时间为146分钟,从最后一个已知井 (LKW) 到治疗的平均时间为543分钟.
结论:
- 成功实施了远程咨询协议,使用关心点的OCT进行RAO诊断.
- 这种新的方法有助于及时诊断和治疗眼科紧急情况.
- 证明了远程咨询服务在管理时间关键条件方面的潜力.
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