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Abstract

OBJETIVO: Analisar a teleconsulta em um hospital público de ensino oftalmológico, durante o período da pandemia do COVID-19.
MÉTODOS: Foram revisados os registros médicos dos pacientes que solicitaram teleconsulta oftalmológica, no período de Junho de 2020 a Março de 2021. Os resultados incluem dados demográficos, sintomas de queixas oculares e hipóteses diagnósticas. Além disso, foram analisados dados da pesquisa de satisfação aplicada após cada teleconsulta.
RESULTADOS: Um total de 161 prontuários foram revisados. A idade média dos pacientes foi de 45.98 ± 17.57 (8 a 90) anos, a maioria mulheres, 113 (70,20%). Apenas 57 (35,60%) eram pacientes acompanhados no hospital previamente. A principal razão pela busca pela teleconsulta foi o erro refracional, 73 (45.43%), seguido de olho seco, 16 (9.93%), pterígio, 13 (8.07%). Outros motivos foram o acompanhamento de doenças prévias como glaucoma, retinopatias, miopia, estrabismo e ceratocone. Quanto a pesquisa de satisfação, 151(93,87%) pacientes responderam a pesquisa on-line. A maioria deles mostrou-se satisfeito com a teleconsulta (94.03%) e fariam uma nova teleconsulta (90.06%).
CONCLUSÃO: A teleconsulta pode auxiliar a saúde pública em oftalmologia podendo ser utilizada em hospitais universitários. Embora o erro refracional tenha sido o motivo mais frequente nas consultas, os pacientes mostraram-se satisfeitos com essa modalidade de atendimento que serve como um serviço de orientação.

Keywords: COVID-19; Telemedicina; Pandemias; Consulta remota; Oftalmopatias/diagnóstico; Hospitais públicos

Abstract

PURPOSE: Access to cataract treatment and diagnostic tools continues to be hindered by financial and logistical barriers. Thus, photography-based cataract analysis via portable devices offers a promising solution for the detection of cataracts in remote regions. In this study, the accuracy of a portable device that is based on the Lens Opacities Classification III System for diagnosing cataracts was analyzed.
METHODS: Photographs of the anterior segment of the eye were taken in a low-light environment, and the pupillary region markings were automatically delineated using infrared photography. The captured images were automatically analyzed using a convolutional neural network. The study group included patients with cataracts, and the control group included patients without cataracts.
RESULTS:A total of 270 eyes were analyzed, which included 143 eyes with cataracts and 127 control eyes. A total of 599 photos were analyzed. The isolated nuclear cataract was the most frequently detected subtype (37.5%), followed by a nuclear cataract associated with a cortical cataract (30.3%). The device's accuracy was 88.5% (Confidence intervals (CI), 83.19%–94.69%), specificity was 84.62% (CI 71.79%–97.30%), positive predictive value was 91.78% (CI 74.36%–97.30%), and negative predictive value was 82.50% (CI 74.36%–97.30%).
CONCLUSION: The portable device is a simplified user-friendly cataract screening technique that can interpret results in remote regions. This innovation could mitigate the occurrence of cataract-induced blindness and prevent premature surgical interventions in early-stage cataracts.

Keywords: Cataract/diagnosis; Diagnostic techniques ophthalmological/instrumentation; Optical devices; Equipment and supplies; Eye-tracking technology