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Impact of automated OCT in a high-volume eye urgent care setting
  1. Richard I Kaplan,
  2. Masako Chen,
  3. Meenakashi Gupta,
  4. Richard B Rosen
  1. Department of Ophthalmology, New York Eye and Ear Infirmary of Mt. Sinai, New York City, New York, USA
  1. Correspondence to Dr Richard B Rosen; rrosen{at}nyee.edu

Abstract

Background/Aims Optical coherence tomography (OCT) has become standard of care in the diagnosis and management of a myriad of retinal and optic nerve pathology. Access to diagnostic equipment and skilled imaging personnel in the after-hours setting is often limited. We examined the utility and diagnostic indications for automated OCT in a high-volume after-hours clinic within an eye institute.

Methods OCT images obtained over a period of 15 months were reviewed in the context of electronic patient records. Residents and fellows were surveyed regarding their experience with the OCT and its value in emergency patient management.

Results 202 patients and 359 eyes were examined. Complaints prompting imaging included flashes/floaters, metamorphopsia, decreased vision and scotomas. Diagnoses included vascular occlusion, retinal detachment, macular hole, cystoid macular oedema and central serous retinopathy. Of the 25 residents and fellows surveyed, most agreed that the OCT that facilitated delivery of optimal urgent management. OCT also aided in the triage of patients to specialty clinics.

Conclusion Expanded access to automated OCT in the urgent care setting shows promise for improving the accuracy and timeliness of diagnosis, which can be critical for optimising patient outcomes. OCT also provides clear, immediate documentation of pathology for substantiating medical decision-making.

  • imaging
  • diagnostic tests/investigation
  • retina

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

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Footnotes

  • Presented at Preliminary results presented as a poster at The Association for Research in Vision and Ophthalmology Annual Meeting, 7-11 May 2017, Baltimore, MD. Current results presented as a poster at The Association for Research in Vision and Ophthalmology Annual Meeting, 29 April to 3 May 2018, Honolulu, HI.

  • Contributors RIK, MG, RBR: conception and design. RIK, MC: data acquisition. RIK, MC, MG, RBR: data interpretation, drafting the article and final approval of the version to be published.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests RBR reports personal fees from Optovue, Allergan, Regeneron, Nano Retina, Opticology, Ocata Medical and Clarity, outside the submitted work. MC, RIK and MG have nothing to disclose.

  • Patient consent for publication Not required.

  • Ethics approval New York Eye and Ear Infirmary of Mount Sinai.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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