Evaluating clinical signs in trabeculectomized eyes

摘要: AIM: To evaluate interobserver agreement for clinical signs in trabeculectomized eyes when examined face-to-face with slit-lamp biomicroscopy (SL) or by remote examination using telemedicine (real-time video imaging; TM). METHOD: A system examining was devised and validated. prospective randomized study then undertaken to compare standard SL TM. Remote performed a 384 kbps Sony 5100 videoconferencing system. Three ophthalmologists each 40 of patients, who had previously undergone trabeculectomy. In rotation, two examiners used biomicroscopy. The third the eye remotely Analysis determine variability presence absence systematic bias between methods. RESULTS: High levels were observed paired examinations (SL/SL) bleb vascularity (score range 0-10) no bias. Paired TM (SL/TM) also showed good vascularity, although spread disagreement wider (95% limits 2.57 vs 2.98 (P=0.054)). For anterior chamber depth, observers agreed within +/- 10% depth 68% 51% (P=0.68). Agreement 'good' wall thickness (kappa=0.63 0.08), height (kappa=0.67 0.1), existence leak 0.19), but poor morphology (kappa=0.26 0.12). SL/TM comparison, fair (kappa=0.39 0.13), (kappa=0.17 0.12), (kappa=0.56 (kappa=0.31 Microcysts not reliably detected either technique. CONCLUSION: may permit reliable assessment eyes. However, is more limited respect assessing thickness. microcysts unreliable both instruments. We propose that appears safe appropriate situations where an ophthalmologist practical.